Intake Form | Writers & Composers - Music Publishing & Song Copyright Submissions

ROYALTY PUBLISHING AUTHORITY

Official Music Registration Intake Form
Royalty Publishing Authority • Atlanta, GA, NYC
HOTLINE: 516.928.6488
Technical Support: cuetrax@gmail.com

Instruction: Please complete all fields to the best of your ability. You may leave any field blank if you do not know the information.

Artist / Writer Information

Artist / Legal Name *


Stage / Artist Name


Email Address *


Phone Number *


Mailing Address


Date of Birth


Country of Citizenship

PRO & Publishing Information

Performing Rights Organization
BMI
ASCAP
SESAC
No Affiliation / N/A

PRO Member / IPI Number


Publisher Name (if any)


Your Ownership % as Writer

Song / Work Information

Song Title


Alternate Titles


Song Duration


Your Role(s)
Writer Composer Lyricist Producer Performing Artist

UPLOAD MUSIC


Optional but Recommended for Mechanical Royalties
Primary Genre


Date of Completion


Release Date


ISRC (if known)


Album / Project Name

Co-Writers & Splits

List Co-Writers (Name – Role – % Ownership – PRO)

Copyright Information

Copyright Claimant(s)


Year of Creation


Country of First Publication


Previously Registered?
(Select) No Yes

If yes, provide details

Consent

I confirm the information provided is accurate to the best of my knowledge.

I authorize Royalty Publishing Authority to use this information for registration purposes.