ARTIST CONTACT INFORMATION

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NOTIFICATION TO CORRIENTELATINA
OF DIRECT LICENSE DETAILS


I, (PRINT NAME) _____________________________________________________________________ of

(PRINT AGENCY/COMPANY NAME) _____________________________________________________,

herein notify CORRIENTELATINA of a direct license with the following details:

1. The title(s) of the composition(s) (If multiple titles, please use the attached Schedule A.)

__________________________________________________________________________________________

2. The names of the writer(s) and publisher(s) of the titles(s) (If multiple titles, please complete

the attached Schedule A): _____________________________________________________________

3. The time period covered by the license: Monthly automatic renewal until termination agreed
upon by both parties in writing 30 days and delivered via Certified U.S. Postal Service.

I acknowledge that (i) I have the legal authority to issue the direct license of which I am herein providing notice
to CORRIENTELATINA and (ii) to the extent that there are other interested parties with shares in the titles
impacted by this direct license, I will be solely responsible for accounting to them with respect to performances
occurring under this direct license. Furthermore, any issues which may arise in connection with the direct
license are not the fault of CORRIENTELATINA. Additionally, in the event that a dispute arises regarding the
direct license, I acknowledge that CORRIENTELATINA is not a party to the direct license and thus, will not be
able to assist me in resolving said dispute. I agree to indemnify, hold harmless and defend
CORRIENTELATINA from any liability whatsoever, based upon my representations that I am authorized to
enter into such direct license.

Signature (and Title if Representative of Artist) :

__________________________________________________________________________________________

Mailing Address & Email:____________________________________________________________________

__________________________________________________________________________________________

Date: _________________

ScheduleA|NoticeofDirectLicense(MultipleWorksSubmission)

ArtistName:__________________________________________________________________________
SongTitle Writer(s)Information Publisher(s)InformationandContact
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