Production Music Form

Application For Production Music License

Please complete this form when you dub music into a production and forward to the production company so they can make an Application for Music Licence. Please review the MCPS Rate Card here to assist you in making your submission.
Notes for Completion Part A, Part B and Part C must be completed and returned before any exhibition of the completed production, as an application to obtain a music licence required under the Copyright Laws. A production is unlicenced until a valid licence in respect of it has been received from MCPS and the licence fee displayed thereon has been paid in full.

PART A
Purchase Order No.
Date of Recording
DD slash MM slash YYYY
Ref. Number
Job No.
Production Title*
Production Co.*
Produced for*
Studio / Facility House
Invoice to*
Production Type (please tick appropriate box(es))*
- Corporate
- Advertising
- Online Productions
- Film
- Retail
- Independent Production Company (IPC)
- Other
Description
PART B
Company making Application for Music Licence
Company Name*
Address
Street Address Address Line 2 City ZIP / Postal Code Country
Telephone No.*
Email*
Contact Name*
Territory or Station
No. of copies
Broadcast Start Date
DD slash MM slash YYYY

*If available at time of application
TV Ads Clock Number

*If available at time of application
PART C
Please remember that the duration of each separate music cue must be declared:*
Disc and Track No. Duration Used Music Title Composer / Arranger Library / Publisher / Copyright Owner

Please click on the '+' icon on the right hand side to add tracks
The information contained in this document is accurate to the best of my knowledge*
- Yes

Production Music Form

Application For Production Music License

PART A

PART B

PART C

in this section…

About IMRO

Music Creators

Music Users

Supporting Music

Disc and Track No.	Duration Used	Music Title	Composer / Arranger	Library / Publisher / Copyright Owner

Production Music Form

Application For Production Music License

PART A

PART B

PART C

in this section…

About IMRO

Music Creators

Music Users

Supporting Music

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