MUSIC PUBLISHER APPLICATION FOR MEMBERSHIP - samro

NON-PROFITMAKING – NO SHARECAPITAL LIMITED BY GUARANTEEAFFILIATED TO THEINTERNATIONALCONFEDERATION OF COPYRIGHTSOCIETIES – CISAC(Reg. No. 1961/002506/09)MUSIC PUBLISHER APPLICATION FOR MEMBERSHIPRead the following instructions before proceeding with theApplicationPlease Note: Completion and submission of this application does notautomatically entitle you to Membership. SAMRO has a formal ElectionProcess and, should you meet the Criteria of Membership, you will benotified in writing.THE APPLICATION FORM MUST BE ACCOMPANIED BY:**Please ensure that the following is attached to your Application.Tick the block on the right hand side to confirm.P O BOX 31609Braamfontein 2017TEL: (011) 712-8000FAX: (011) 403-1834EMAIL:customerservices@samro.org.za1. A copy of the contract (Deed of Assignment) that the business usesin obtaining rights from composers/authors/arrangers.2. A list of all the titles of all the musical works in respect of which thebusiness has obtained rights from composers/authors/arrangers,indicating the names of such composers/authors/arrangers,together with copies of the Deeds of Assignment executed by suchcomposers/authors/arrangers to the Firm.3. Copies of all contracts (“sub-publication agreements”) whereby thebusiness has acquired the rights in musical works in the catalogueof foreign publishers.4.5. Copies of all the business music publications.6. The names and nationalities of the partners, members or directorsin the business, showing the extent of their holdings.7. A copy of the partnership agreement, indicating in particular theprovisions regarding disposition of the rights acquired by thebusiness in musical works in the event of a termination of thepartnership.

8. In the case of a Close Corporation, a copy of the certificate ofincorporation9. In the case of a company (Pty) Ltd, a copy of the memorandum andarticles of association.Name of Music Publishing Company / Firm:Type of Music Company: Publishing Firm / PartnershipPublishing Company Pty Ltd.Publishers – Close CorporationComplete one of the following sections according to your answer above:Publishing Firm / Partnership:Name(s) of Proprietor or PartnerAuthorisedSignatory1 YesNo2 YesNo3 YesNo4 YesNoComposer /Author Memberof SAMROYesNoYesNoYesNoYesNoPublishing Company Pty Ltd.:ORName(s) of Proprietor or PartnerAuthorisedSignatory1 YesNo2 YesNo3 YesNo4 YesNoComposer /Author Memberof SAMROYesNoYesNoYesNoYesNoPublishers – Close Corporation:OR

Name(s) of Proprietor or PartnerAuthorisedSignatory1 YesNo2 YesNo3 YesNo4 YesNoComposer /Author Memberof SAMROYesNoYesNoYesNoYesNoDate of Inception:YYYY/MM/DDCountry of Registered Office:Company Registration Number:Physical Address: Postal Address:Code:Code:Telephone Number:Cell Phone Number:Fax Number:Email:Trading Name:Is the Publishing Company a Member of another Rights AdministrationOrganisation?Yes NoIf Yes, specify:SARRAL DALRO NORM CISAC SOCIETIESBANK ACCOUNT DETAILS

Full Names: (as per ID)Account Holder’s Name:Bank Name:Branch Code:Account Number:Name of Branch:Type of Account:APPLICATION FOR MEMBERSHIP -ADDENDUMELECTION OF RIGHTS TO BE ADMINISTERED BY SAMROSAMRO will administer the following rights on my behalf:- PERFORMING RIGHTS- MECHANICAL RIGHTSIf you do not want SAMRO to administer Mechanical rights, pleasedraw a line through "MECHNICAL RIGHTS" above and sign your namenext to it.DECLARATIONI/We, herewith apply to be admitted as a member of the Southern AfricanMusic Rights Organisation (SAMRO) in terms of its Memorandum andArticles of Association. If admitted, I agree to abide by the terms of thosedocuments, as well as the Organisation's Rules and Regulations. I/Weagree to abide by the terms of those documents as well as theOrganisation’s Rules and Regulations.I/We hereby declare that I/We are not members of any performing and/ormechanical rights Organisation or Society in any other country, or SAMRO

territory and that the details contained in this Application form arecorrect.Signed at on this day of 20on behalf of(the business)Full Names of authorised signatory/ies:Signature(s):Return completeddocuments to:SAMRO Customer ServicesDepartmentPO BOX 31609BRAAMFONTEIN2017NameReview DateJodi Goldstein 23/04/2012Mackson Motedi 30/04/2012