Recording Mechanical License : Please fill out the following form. Please print your completed form if you would like to have a copy for your records.
The undersigned (hereinafter referred to as the "Publisher"), owns the copyright or controls the rights to reproduce in phono-records and to distribute phonorecords of the below copyrighted musical work.
PHONORECORD NO. :
RECORD COMPANY :
You have advised the Publisher that you wish to use said copyrighted work under the compulsorylicense provision of Section 115 of the Copyright Act relating to the making and distribution ofphonorecords of such work.
Upon your doing so, you shall have all the rights which are granted to, and all the obligations whichare imposed upon, users of said copyrighted work under the compulsory license provision of theCopyright Act after distribution of phonorecords of the copyrighted work to the public in the UnitedStates by another person under the authority of the copyright owner, except that with respect tophonorecords thereof made and distributed by you:
1. You shall pay royalties and account to the Publisher quarterly, within 45 days after the end of eachcalendar quarter, on the basis of phonorecords made and distributed; and
2. For such phonorecords made and distributed, the royalty shall be the statutory rate in effect at thetime the phonorecord is made (and any royalty stated in terms of a percentage of the statutory rateshall apply to the statutory rate at such time); and
3. This compulsory license covers and is limited to one particular recording of said copyrighted workset forth above as performed by the artist and on the phonorecord number set forth above; and thiscompulsory license does not supersede nor in any way affect any prior agreements now in effectrespect to phono-records of said copyrighted work; and
4. If you fail to account to Publisher and pay royalties as herein provided, Publisher may give youwritten notice that, unless the default is remedied within 30 days from the date of the notice, thiscompulsory license will be automatically terminated. Such termination shall render either the makingand/or the distribution of all phonorecords for which royalties have not been paid, actionable as actsof infringement under, and fully subject to the remedies provided by the Copyright Act.
5. You need not serve or file the notice of intention to obtain a compulsory license required by theCopyright Act.
We acknowledge receipt of a copy hereof :
Record Company :
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