SYNCHRONIZATION
LICENSE REQUEST
Home Grown Music, Inc. / BMI
Sommersongs Music Co. / BMI
Ripparthur Music, Inc. / ASCAP
Artphyl Music, Inc. / ASCAP
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730 Island View Circle
Port Hueneme, CA 93041
Ph/fax (805) 271-4062
Composition
Title: _______________________________
Writer(s):
_____________________________________
Master
Title: ___________________________________
Artist: ________________________________________
Usage:
_______________
Duration
(min:sec): __________
Media:
_________________________________________
Territory: _______________________________________
Term
Start-End:
__________________________________
Your Project
(TV/Film/Video) Name: _____________________
Scene Description: ___________________________________
___________________________________________________
* * * * * * * * * * * * *
Contact
Name:
____________________________________
Company
Name:
___________________________________
Address:
_________________________________________
_________________________________________________
Contact
Phone/Cell #: _____________________