Title Report

First Name

Last Name

Email Address

Company Name

Address

City

State

Zip Code

Telephone

Project Title

Legal Opinion Legal Opinion Yes No

Proposed Use Proposed Use Theatrical Motion Picture Documentary Television Motion Picture/Television Series DVD Digital/New Media

Other Use(s)

Television network/streaming site

Brief Plot Synopsis

Additional Information

Schedule of Report Schedule of Report 7-10 Business Days 2-3 Business Days Next Business Day

Preferred payment method Preferred payment method Check Wire Transfer PayPal (invoice emailed separately)