Music Users

T +27 11 561 9660 • F +27 11 789-5799 • E licencing@sampra.org.za

Sunnyside Office Park, Sentinel House,
32 Pincess of Wales Terrace, Parktown,
Johannesburg, South Africa, 2001

P.O. Box 31600, Braamfontein, 2017

sampra.org.za

APPLICATION FOR A LICENCE TO COMMUNICATE SOUND RECORDINGS TO THE PUBLIC

• Please complete in BLOCK LETTERS all sections of the application which are relevant to your business and sign the last page of this form.
• This information is required for SAMPRA to process your licence application. SAMPRA will process your personal information in accordance with applicable laws. Please refer to our Licensee Privacy Notice for more information.
• Kindly refer to the relevant SAMPRA tariffs when completing the application(www.sampra.org.za). The calculation of the applicable licence fees are subject to the provisions of the aforementioned tariffs.
• The annual licence fee(s) levied by SAMPRA are subject to a minimum fee as provided for in the various SAMPRA tariffs.
• It is suggested that you retain a copy of this form for your records before returning the completed form to our offices.
• Kindly notify SAMPRA if there are changes to the use of sound recordings at your place of business so as to avoid the risk of copyright infringement.
• If you require assistance in completing the form, please contact us on 0861 SAMPRA (0861 726772) or 011 – 561 9679 or via email licensing@sampra.org.za.
• PLEASE READ THE SAMPRA TERMS AND CONDITIONS AND LICENSEE PRIVACY NOTICE ATTACHED HERE TO WHICH FORM PART OF THE SAMPRA LICENCE AGREEMENT.