JAMMS DUBBING LICENCE APPLICATION FORM (JDL 0015)

SECTION 1 (If applicant is an individual)

Title *

Alias

Name *

First

Middle

Last

Date of Birth *

Country of Birth *

Nationality *

Permanent Address *

Address Line 1

City

State / Province / Region

Country

Mailing Address: (if different from Permanent Address)

Address Line 1

City

State / Province / Region

Country

Are you a Citizen or Permanent Resident of any other country?

Yes
No

Telephone No. *

Email *

Mobile No. *

Work No.

Taxpayer Number: *

Multiple Choice

TRN
TIN
Other (please state)

SECTION 2

Checkboxes

Sound System Owner
Independent Sound System Selector (ISSS)*
Itinerant Disk Jockey (IDJ)
Fitness Instructor (FI)

*If ISSS or IDJ are employed as full time employees of a Sound System and do NOT ply their trade independently or are employed to any other Sound System, then the Sound System Owner Licence will cover the ISSS or IDJ.

SECTION 3

SOUND SYSTEM INFORMATION (THIS SECTION FOR SOUND SYSTEM OWNERS)

Name of Sound System

Sound System HQ Address *

Address Line 1

City

State / Province / Region

Country

Does the sound system employ full time Selector/s or On Demand Help? *

Yes
No

What are the Selectors’ Names?

First Name *

Selector Name *

Surname *

Multiple Choice

Employee
On-Demand Help

SECTION 4 (DETERMINATION OF APPLICABLE LICENCE TYPE)

What type of devices do you store music on? (you may tick more than one) *

Other type of devices *

How do you obtain music? (you may tick more than one) *

How do you obtain music? *

On average how many recordings per year do you add to your collection? *

Approximately how many recordings are currently in your collection? *

What is the capacity of your storage device/devices? *

SECTION 5 (Declaration of Connected Party Status or Conflicts of Interest)

Are you a: *

Record Producer
Executive Producer?
Label Owner?
Studio Personnel?

If you own your own music label list the label names below *

SECTION 6

If applicant is a Registered Company, state:

Name of Co. *

Date of Incorporation *

Name of Director (1) *

Registered Address of Company *

Address Line 1

City

State / Province / Region

Country

Country of Incorporation *

Company TRN/SSN *

Name of Director (2)/Company Secretary *

Name of Representative Designated by Company *

Work No.

Mobile No. *

Email *

SECTION 7

Applicant warrants that Applicant is authorized to complete this application that all information given to JAMMS hereon is accurate and not misleading in any material particular.

SECTION 8

This application does not obviate the need for Applicant to obtain other permits, consents or other authorizations that may be required by Law or Statute, such as a JACAP Licence.

By submitting this form you assert that the information entered here is accurate and true. *

By submitting this form you assert that the information entered here is accurate and true.

I have read and agree with the Jamaica Music Society Privacy Policy