Notification of Works Notification of Work Form Notification of Work Form Song Information Is this registration part of a riddim? YesNo Name of Riddim Song Title Alternative Title if one: Performer Name Date of Release Duration of Song Musical Genre Is this song an amended registration? Yes No Is this a remix? Yes No If based on Public Domain (PD) Words/Music Arrangement of PD music and new wordsAdaptation of PD words and new musicArrangement of PD music and adaptation of PD wordsArrangement of PD music and unchanged PD wordsAdaptation of PD words and unchanged PD musicArrangement of PD music only (instrumental)Other (if other please give details) Do you have a Publisher? Yes No Publisher Name Is this written for a Film, TV Program or TV Series Yes No Does this composition include part of a pre-existing work? No A medley Copyrighted Words/ lyrics Both (lyrics and music) If written for TV Program/Film/Series Title of program Producer Name Phone E-mail Provide Authorisation for Use of Copyright Words/Medley Title of Original Work: Name of original composer Attach Agreement Drop a file here or click to upload Choose File Maximum file size: 516MB plus1 Add minus1 Remove Are you registering an Advertising Jingle? YesNo Is this song registration a part of a new member application? Yes No Music for Use in Advertisements Agency Title for Advertising Jingle Product: Script Title Performer If you are human, leave this field blank. Next
