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Intergram an independent society of performers and producers of phonograms and audiovisual fixations Klimentská 1207/10 ID No.: 00537772 110 00 Praha 1 Czech Republic Tax ID No.: CZ00537772 e-mail: [email protected] Bank details: KB Prague 2 Tel: +420 221 871 932 Account No.: 47838-011/0100 Fax: +420 221 871 906 IBAN:CZ0201000000000047838011 www.intergram.cz 01 – Country Code 02 – Registrant code 03 – Year of reference 04 – Registration Code 05 – Registrant name Handled by: Delivered on: Approved by: Recording identification in accordance with ISRC (Recording Protocol) I. Producing of the Recording 06 – Recording Format M – mono S - Stereo 07 – Recording System A – analogue D – digital fixation (videoclip) 08 – Recording finished on: 09 – Recording made at: (Studio details) 10 – Master Nr. 11 – Catalogue Nr. / Recording Nr. 12 – Label 13 – Producer (Date of Birth) 14 – Producer (Surname, Name, Title) 15 – Sound Enginner (Date of Birth) 16 – Sound Enginner (Surname, Name, Title) 17 – Music Director (Date of Birth) 18 – Music Director (Surname, Name, Title) 19 – Mixed by: (Date of Birth) 20 – Mixed by: (Surname, Name, Title) 21 – Total Recording Length II. Authors of the Recording 22 – Recording Title 23 – Composer (Date of Birth) 24 – Composer (Surname, Name, Title) 25 – Lyrics by: (Date of Birth) 26 – Lyrics by: (Surname, Name, Title) 27 – Arranged by: (Date of Birth) 28 – Arranged by: (Surname, Name, Title) 29 – Language of recording Z – phonogram O – audiovisual 01 – Country Code 03 – Year of reference 02 – Registrant code 04 – Registration Code Recording title III. Performers participating on the Recording Date of Birth Surname Firstname Country of residence Fill share or performance Signature of the Share in performer Performance % Fill in always either Share or Performance. When the Share in % is not set, the Performance is decisive. Share – define Performer´s share on the Recording in % (sum of all shares of Performers must be 100%) Performance – in pop-music: A – soloist, B – Main performance, C – Minor performance - in classical music: D – soloist, E – conductor, F – choirmaster, G – orchestra member, H – chorus member, I – member of chamber chorus If the Performer participates with his/her performance in more categories, fill each performance in a separate row. Data processed by – Surname, Firts Name, Title Date: Signature