:	.

COPYRIGHT DECLARATION
Cat. B/C, v5

Title:

Catalogue Number: :

Company name:

Registered address:

Company reg.No

Company VAT No:

organization of BIEM :

GZ  Media, a.s., sídlo: Tovární 340, 267 12 Loděnice, IČ: 27380068, zapsaná: Městský soud v Praze - B 10185.
Tel: +420 311 673 239, Fax: +420 311 673 498,  www.gzcd.cz

Are you the Intellectual Property Rights Owner (IPR) for the entire disc contents?

If not IPR owner, proof of replication licencing from IPR owner for licensed tracks may be required.
Complete the section(s) below describing the content that is applicable to the media you have ordered. MP3 or Enhanced Disc content requires completion of both ROM and Audio sections.

Distribution:

Countries where distributed:

CD - ROM / DVD – ROM Content

If not IPR owner, list all included non/owned software, freeware, and shareware products:

Title ...............................................size......................content type.................IPR owner......................... Necessary distribution licensing documentation from the IPR owner may be required.

CD / DVD Audio, vinyl Content

Is it a COMPILATION?

An attached list of track title, artist, and IPR owner is required.

Artist(s)........................................ track title.......................... time................... IP owner.................... If not IPR owner, proof of replication licensing from IPR owner for licensed tracks may be required.
Please confirm that (mark your choice with a circle) the Client:

a standard contract with a member organization of BIEM:

a work by work contract for the ordered product registered at a member

Note.: The Client agrees to provide GZ on their regest  with a copy of this contract.

The product	any protected production/s and the Client is not represented by any member organization of BIEM.

CD / DVD - VIDEO Content

(If Audio is separately licensed, complete Audio section (necessary Audio/Video Synchronization licensing may be required).

If not IPR owner, proof of replication licensing from IPR owner may be required.

does not contain

Organization

has

Organization

has

YES

NO

Other

Free to public

Within an organization

Retail

YES

NO

COPYRIGHT DECLARATION
Cat. B/C, v5

The above mentioned company (hereinafter referred to  as  „the Client“) hereby gives the  following
warranties and indemnities to GZ Media, a.s.(hereinafter referred to as „GZ“):

1.

That the Client is the sole owner of the copyright in the material supplied for reproduction, or
alternatively that the Client has been granted the right to reproduce and distribute the material described in the order by all copyright owneres.
That the Client has not granted an exclusive License or Assignment of the rights in clause 1 hereof to any other party and that the material does not infringe the copyright or any other rights of any other party.
That the material does not contain anything of an obscene or illegal nature.
That the Client will keep GZ fully indemnified against all losses and all actions, claim proceedings, costs and damages and all legal costs or other expenses arising out of any breach of any of the above warranties.
That the Client agrees to provide GZ on their request with all relevant information, papers and documents (e.g.license agreements) that GZ shall reasonably require to determine the ownership of the intellectual property at issue.
The Client agrees that despite any non-disclosure agreements that may be in effect to the contrary, GZ may consult all applicable governing bodies (i.e. IFPI, BSA, CDSA, RIAA, BIEM, OSA, etc.) concerning intellectual property rights ownership. In such consultation GZ shall disclose only that information necessary to determine the ownership of the intellectual property at issue.
The Client agrees that GZ may retain components or products for a limited period to determine the ownership of intellectual property at issue.

2.

3.
4.

5.

6.

7.

 	Date : 	Client´s stamp (if applicable):

 	Autohorised Signatory : 	

 	Printed Name : 	

 	Position held : 	

GZ Media, a.s., sídlo: Tovární 340, 267 12 Loděnice, IČ: 27380068, zapsaná: Městský soud v Praze - B 10185.
Tel: +420 311 673 239, Fax: +420 311 673 498,  www.gzcd.cz