NAME: 
ADDRESS: 
         
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  STATE: 
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 E-MAIL: 


TITLE OF PROJECT: 


LOGLINE AND BRIEF DESCRIPTION: 




PREVIOUS SUBMISSIONS OF THIS MATERIAL:

TO WHOM: 
   DATE: 
 RESULT: 


HAS THIS MATERIAL BEEN SUBMITTED TO COMPETITIONS? IF YES:

NAME OF COMPETITION: 
     YEAR SUBMITTED: 
             RESULT: 


DO YOU HAVE AN AGENT, MANAGER, OR LAWYER? IF YES, PLEASE LIST:

   NAME: 
COMPANY: 
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BACKGROUND (produced credits, if any): 

1. Sole Proprietor: Seller represents and warrants to Buyer that Seller is the sole and exclusive proprietor, throughout the world of that certain original literary material written by entitled ("the Literary Material").

2. Facts: Seller represents and warrants to Buyer that the following statements are true and correct in all respects with respect to said literary material:

(a) Seller is the sole author of the Literary Material or enjoys the exclusive right to contract on behalf of himself and any and all other writers involved in the Literary Material.

(b) The Literary Material was first published on by , under the title , and was registered for copyright in the name of , with the National Creative Registry under the registry #.

(c) No Motion Picture or dramatic version of the Literary Property, or any part of it, has been manufactured, produced, presented or authorized; no radio or television development, presentation or program based on the Literary Property, or any part of it, has been manufactured, produced, presented, broadcast or authorized; and no written or oral agreements or commitments at all with respect to the Literary Property or with respect to any right therein, have previously been made or entered by or on behalf of Seller (except with respect to the publication of the Literary Material as set forth above).

3. No Infringement or Violation of Third Party Rights: Seller represents and warrants to Buyer that Seller has not adapted the Literary Property from any other literary, dramatic or other material of any kind, nature or description, nor, excepting for material which is in the public domain, has Seller copied or used in the Literary Property the plot, scenes, sequence or story of any other literary, dramatic or other material; that the Literary Property does not infringe upon any common law or statutory rights in any other literary, dramatic, or other material; that as far as Seller has knowledge, no material in the Literary Property is libelous or violative of the right of privacy of any person and the full use of the rights in the Literary Property which are covered by the within option would not violate any rights of any person, firm or corporation; and that the Literary Property is not in the public domain in any country in the world where copyright protection is available.

4. No Impairment of Rights: Seller represents and warrants to Buyer that Seller is the exclusive proprietor, throughout the world, of the rights in the Literary Property which are covered by the within option; that Seller has not assigned, licensed nor in any manner encumbered, diminished or impaired these rights; that Seller has not committed nor omitted to perform any act by which these rights could or will be encumbered, diminished or impaired; and that there is no outstanding claim or litigation pending against or involving the title, ownership and/or copyright in the Literary Property, or in any part of it, or in the rights which are covered by the within option. Seller further represents and warrants that no attempt hereafter will be made to encumber, diminish or impair any of the rights herein granted and that all appropriate protections of such rights will continue to be maintained by Seller.

Without limiting any other rights Buyer may have in the premises, Seller agrees that if there is any claim and/or litigation involving any breach or alleged breach of any such representations and warranties of Seller, the option period granted hereunder and any periods within which Buyer may, pursuant to the provisions of Clause 3 hereof, extend the option, shall automatically be extended until no claim and/or litigation involving any breach or alleged breach of any such representation and warranties of seller is outstanding, but in any event not for a period more than one (1) additional year. Any time after the occurrence of such a claim and/or litigation until the expiration of the option period, as extended, Buyer may, besides any other rights and remedies Buyer may have in the premises, rescind this agreement and in such event, despite anything else to the contrary contained herein, Seller agrees to repay Buyer any monies paid by Buyer to Seller hereunder concerning the Property and any reasonable amounts expended by Buyer in developing or exploiting the Property. Without limiting the generality of the foregoing, Seller agrees that Seller will not, any time during the option period, exercise or authorize or permit the exercise by others of any of the rights covered by the option or any of the rights reserved by Seller which are not to be exercised or licensed to others during any period therein specified.

Signature (type full name):