Educational Program, Work and Other Subject-matter Record-keeping Regulations (SOR/2001-296)

Regulations are current to 2012-05-14

SCHEDULE

(Subsection 6(1))

INFORMATION RECORD

Educational Institution identifier (if assigned):
Name and address of institution:
Contact name:
Telephone: Facsimile: E-mail:
Details of Program, Work or Subject-matter
Copy identifier:
Title of program, work or subject-matter:
Other identifying information:
[e.g. episode title, subject, segment description, song title(s)]
Duration of segment copied: minutes
Date of broadcast (yy/mm/dd): Time of broadcast:
Name, network, call sign or other identifier of the broadcaster:
Record of Public Performances
(List only performances for which royalties are payable)
yy/mm/ddyy/mm/dd
(Use separate sheet to list additional performances)
Record of Destruction
I certify that the copy of the program, work or subject-matter identified above has been destroyed.
Name: Title:
Signature: Date of Destruction (yy/mm/dd):