Copyright License Request for Indie Name

Please complete the license request information below to the best of your ability.

- Required Field

Contact Info

Name:
First  
Last 
Email:    
Organization:  
Address:  
 
City:  
State:  
Zip:  

How will the copyright be used? (request is limited to one product - if you have multiple products you will need to submit a new request for each product)  

Details About The Product You Are Creating:

Product Title:  
Artist:  
Release Date:  
Selling Price:  (Do Not include "$" in Price)    
# of Copies:    
# of Songs:    
 
Will your content be streamed online?

List of Copyrights to be licensed

  Title Author Runtime Album UPC# ISRC#
1.     
2.     
3.     
4.     
5.     
6.     
7.     
8.     
9.     
10.     

Description of Use  


No more than 4 tracks will be licensed from a single album.
Upon receipt of your application, you will be invoiced for fees due ($22 licensing fee + royalties).
Enter the code shown: