DART Payment Verification
Please complete all fields with as much information as possible
Contact Information
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Rightsholder Verification
Upload your last DART PayPal Statement or PayPal email confirmation
*
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Upload a list of titles, ISRC numbers and/or UPC number associated with your release (PDF or XLSX)
*
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of
Payment Information
Name of Financial Institution
*
Financial Institution Address
*
ABA Routing Number
*
Account Number
*
Name on Account
*
Account Type
*
Personal Checking
Personal Savings
Business Checking
Business Saving
Please upload a signed IRS Form W-9
*
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Submit
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