Date
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Licensee Name (organization)
*
Term of License (YEARS)
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1
3
Quoted License Fee
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Licensee Name (organization)
*
Licensee Address
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Street Address
Street Address Line 2
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By: Paul Heinzelmann
Its: Owner
Signature ________________________________
Patsy Productions, LLC
Licensee (Organization)
*
signature
*
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example@example.com
Film format for your library
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MP4
DPC
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FILM SCHOOL TIER 1
$800.00
$
800.00
YEARS
YEARS
1
1
2
3
1
2
10
1
2
FILM SCHOOL TIER 2
$600.00
$
600.00
YEARS
1
3
10
FILM SCHOOL TIER 3
$400.00
$
400.00
YEARS
1
3
UNION OR GUILD
$800.00
$
800.00
YEARS
1
3
NON-PROFIT ORGANIZATION
$500.00
$
500.00
YEARS
1
3
FOR-PROFIT COMMERCIAL
$1,200.00
$
1,200.00
YEARS
1
3
Product Name
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
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