Mandatory Form

RIGHT HOLDER MANDATORY FORM

Independent Music Performance Rights Association of South Africa.

STRATEGIC OBJECTIVES OF THE IMPRA
• To ensure that its copyright owners and performers members complies with legislation.
• To ensure royalties accesibility for all performers and production nationwide and Market access.
• To ensure license income generated from usage of sound (Needle time) recordings is advocated by its license holder IMPRA
in the country and into the continent accrue to rights owners (Record Companies / Producers and performers.
• To exclusively negotiate and deliver Collection and Distribution of Needle time Royalties to its members.
• By becoming a member of IMPRA,You are granting permission to IMPRA the right to license,collect and distribute monies
from Users.

MEMBERSHIP DETAILS

1. Full Company Name:

2. Name & Surname: (contact-person)

3. Registration No: (if Company or Close Cooperation)

4. ID numbers of directors or members or nominated person: (if applicant is a company or a close corporation)

4.1. If group, list co members

5. Physical address:

6. Postal address:

7. Cell no:

Alternative phone:

Fax no:

Email:

8. Copy of certified ID of member

9. Number of audio samples of products: (2minimum).


10. If you trade under name or style or label other than the name set out above please list

11. Declaration of other participants in the sound recording, if available please list the names and surname, Contact details:

12.If you market, advertise and sell records outside South Africa, please list 3 examples

13.All the applicants of IMPRA hereby acknowledge through signing this application form that they are binding
themselves to the MOI of IMPRA attached to the website of IMPRA

IMPRA CONFIDENTIAL

15. Bank account details:
Account Name:

Bank Name:

Account Number:

Account Type:

Branch Code:

Please indicate if you belong to any organisation in the music industry:
AIRCOAESAMPASAKUMISA or NAMBIDZADEVHULA.IMC
Name of Applicant:

Signed by Application:

Who warrants his/her authority hereto:
Date:

Signature (Sign With Mouse Or Touch On Mobile)
[sign* sign-386]

Mandate given to IMPRA
Accepted and Confirmed by IMPRA (Independent Music Performance Rights Association) Official:
(Digitally Stamped)

GENERAL INDEMNITY.
Any person receiving monies that are not to him or her,such person is obligated to return such monies to IMPRA,
Any person receiving Monies,automatically Indemnifies IMPRA for the receipt of such monies, IMPRA retains the right to
institute the legal action or take any appropriate steps to recover monies from such persons.