Mechanical Request Form

 

PLEASE READ

This is a Beta Test version of our on-line mechanical licensing system. It will process and handle mechanical license requests. If you do not receive a reply or mechanical license within 2 weeks, please contact us to let us know what is wrong with the system so we can fix the problems.

In order to process the volume of requests we get, priority will be given to those forms that are entirely filled in. For more information on licensing, please read the links on this website. They are very helpful and written to make this process easier for you.

All fields are mandatory except for FAX # if you don't have one.

Requestor Information

Your Name:    

Phone #:

Fax #:

Email:   

Record Label (or Your Name if no Label name):

Label Address (if you are not using a Record Label, provide your mailing address)

Address:

City:

State/Providence:

Zip Code:

About Your Record

Exact name of Artist or Group that has recorded this song:

Record Title:

Record Number:

Release Date:

Song Playing Time:

Anticipated Quantity of Units:
Over 5,000
Under 5,000

CONFIGURATION QUANTITY
CD/TAPE/VINYL
DOWNLOAD (please estimate)
TOTAL
CONFIGURATION
CD/TAPE/VINYL
DOWNLOAD

DOWNLOAD mechanical licenses (i.e. DPD) will only be issued if you have a digital UPC # and an ISRC #:
Digital UPC #:

ISRC #:

Information About The Song You Wish To Use

Title (s):  

Writer(s):

Publisher(s):

 

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