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You can download individual interactive forms for future projects or use online request form below.
Music Clearance Request Form -
doc
|
pdf
Musicology Submission Form -
doc
|
pdf
Please read
TERMS & CONDITIONS
Online Request Form
Please fill out the form and follow all instructions. If you have any questions please send an email to
info@musiodata.com
Type of Request:
<-- Please Select -->
Music Clearance Request
Musicology Submission
Name:
Required
Title:
Company:
Street Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Email:
Required
Phone:
Required. You can use spaces or hyphens if you wish.
Rush Priority?
<-- Please Select -->
Yes
No
Preferred Contact Method:
Phone
Email
This Area is for Music Clearance Request Only:
I CERTIFY THAT IF THIS WORK IS REMINISCENT OF ANY OTHER KNOWN PIECE, GROUP OR SINGER, OR IF I HAVE BEEN ASKED TO CREATE MUSIC SIMILAR TO SOMETHING ELSE, I WILL INDICATE THOSE TITLES OR ARTISTS BELOW: IF NOT, CHECK HERE:
ANY SAMPLES USED MUST BE LISTED WITH SOURCE INFORMATION HERE: IF NO SAMPLES HAVE BEEN USED, CHECK HERE:
MUSIC TO BE CLEARED (LIST TITLE(S), TIME (TV/R) OR OTHER IDENTIFIERS:
This Area is for Musicology Request Only:
Please Check all that apply:
Musicology Analysis
Sample Analysis
Initial Consult
Public Domain Research
Song License Inquiry
Litigation Matter
Prior Art Analysis
Other
Please indicate song titles and other pertinent information:
Client:
Product:
Agency:
Music Company:
Send Bill to:
Address:
BY CHECKING THIS BOX, I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
UNLESS INVOICE IS TO BE PAID BY ANOTHER PARTY LISTED ABOVE, I AGREE TO PAY THE APPLICABLE FEES FOR SERVICES RENDERED.
Additional Questions:
BY CHECKING THIS BOX, I CERTIFY THAT I HAVE READ AND UNDERSTAND THE
TERMS & CONDITIONS
MUSICOLOGY SERVICES FOR ATTORNEYS, ADVERTISERS, MUSIC COMPANIES, FILM COMPANIES AND OTHER ENTERTAINMENT PROFESSIONALS