APRA

APRA Jingle Reporting Form

Use this form to report jingles and community service announcements that you have written for:

use in Australia and New Zealand for commercial radio and television stations

DO NOT use this form for:

jingles broadcast overseas (there is a separate Overseas Jingle Form for this purpose)
station IDs (use local index cards or on-line registrations instead)
jingles or community service announcements on SBS, ABC or community radio (use local index cards or on-line registrations instead)
jingles used in cinemas or on Pay TV
jingles used on-line (downloaded, streamed etc.)
music other than jingles and community service announcements (use local index cards or online registrations to register all other types of music

Lodge your jingle claims by 31 July each year.

Need help?

Contact the APRA office in your state.
Australian Members: apra@apra.com.au Website www.apra-amcos.com.au
New Zealand members: nz@apra.com.au Website: www.apra.co.nz

* denotes a required field

!!IMPORTANT!!

Before you start Click Here for guidelines on how to claim your Jingle Broadcasts.

A quick guide on "How to keep track of your Jingle Submissions"

Section 1: Declaration of accuracy

* Surname :
* First Name :
Other Given Names:
* Email :
Home Phone #:
Mobile Phone #:
Business Phone #:
I understand that APRA will use the information I have provided on the form to calculate the royalties to be paid to members. I declare that the information contained on this form is true and correct I understand that APRA may ask me to verify broadcast details. APRA can contact the person listed below to confirm these broadcast details.
* Name of person who can verify broadcast details:
* Their telephone number:
Their email:

Section 2: General Information

Period covered by this form

* Period covered by this form - 1 July to 30 June

* Was this jingle reported in APRA's last distribution?
Yes No

Section 3: Jingle Details

* Client Name i.e Goodman Fielder
* Product Title i.e Tip Top brand
* Product Description i.e High Loaf
* Name of advertising agency
* Length of the commercial mins:secs
Please enter JG/GW No. (if known)
* Please indicate whether 'corporate' or 'product'
Key number (if known)

* Did the jingle use an original/existing piece of music licensed for advertising use?
Yes Publishers ONLY please complete A,B,C below then go to Sect 4.
No - Go straight to section 4

A. Title of Music
B. Original Writer(s)
C. Original Publisher
D. Please provide ID number (if available)

Section 4: Jingle Ownership Details

Please list the names and contributions of all authors/composers involved in creating this jingle. For example, if lyrics are included with this jingle and you did not write the lyrics, then please give us the author's name or, where relevant, write 'agency lyrics'.

* Name (Indicate publisher if relevant)		* Contribution	* Percentage of share of royalties (must total 100% to continue)	Writer(s) IPI number (if known)
Surname	Given names	* Contribution		Writer(s) IPI number (if known)

Percentage of share of royalties (must total 100% to continue)

For a definition of Agency Lyrics and Commercial Tags please click here

1. * Did this jingle use Agency Lyrics?	Yes	No
2. * Did this jingle use an existing 'TAG'?	Yes	No

Section 5: Coverage in Australia

(Complete only if your jingle was broadcast on radio or television in Australia)

5A: Australian Radio Broadcasts

* Was your jingle broadcast on radio in Australia?
No - go straight to section 5B
Yes - tick the states/territories where the jingle was on radio
- NSW
- VIC
- QLD
- SA
- WA
- TAS
- ACT
- NT

If your jingle was broadcast in a local area only (that is, it was not broadcast nationally or statewide), list the names of the capital city and country radio stations which broadcast your jingle.

CITY/TOWN	STATION NAME











TOTAL

COUNTRY STATION	STATION NAME











TOTAL

5B: Australian Television Broadcasts

* Was your jingle broadcast on television in Australia?
No - go straight to section 6A
Yes - tick the states/territories where the jingle was on television
- NSW
- VIC
- QLD
- SA
- WA
- TAS
- ACT
- NT

If your jingle was broadcast in a local area only (that is, it was not broadcast nationally or statewide), list the names of the capital city and country radio stations which broadcast your jingle.

CITY/TOWN	STATION NAME











TOTAL

Country Station	STATION NAME











TOTAL

Section 6: Coverage in New Zealand

(Complete only if your jingle was broadcast on radio or television in New Zealand)

6A: New Zealand Radio Broadcasts

* Was your jingle broadcast on New Zealand radio?
No - go straight to section 6B
Yes - check the territories where the jingle was on Radio
- National
- South Island only
- North Island only
Local Station (indicate local regions covered below)
- Northland
- Auckland
- Taranaki/King Country
- Wellington
- Christchurch
- Waikato
- Bay of Plenty
- East Cape/Poverty Bay
- Manawatu Palm North
- Dunedin
- Other South Island Towns -

6B: New Zealand Television Broadcasts

* Was your jingle broadcast on television in New Zealand?
No - go straight to the end to submit
Yes - check the territories where the jingle was on television National
- TV1
- TV2
- TV3
- TV4
- Other -
South Island
- TV1
- TV2
- TV3
- TV4
- Other -
North Island
- TV1
- TV2
- TV3
- TV4
- Other -
Other
- SKY

PRIVACY NOTICE

The information you are providing may be personal information under the Privacy Act. Information collected is only for the business purposes of APRA and will not be disclosed to any third parties except in accordance with the privacy policy of APRA. The privacy policy can be obtained from APRA.

Australian Contact Information :
6-12 Atchison Street, St Leonards NSW 2065
Phone: 02 9935 7900
Fax: 02 9935 7970
Email: apra@apra.com.au
Web: www.apra-amcos.com.au

New Zealand Contact Information:
Unit 113, Zone 23, 21-23 Edwin Street, Mount Eden
Phone: 09 623 4717
Email: nz@apra.com.au
Web: www.apra.co.nz

APRA has five offices in Australia and an office in New Zealand. Click here for further contact details for your area.