US Territories Publishing and Copyright Agreement
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PDF Publishing and Copyright Agreement Form

A Publishing or Copyright Agreement is a contract between the creator of a work (e.g. author of a book) and a party who will be receiving the rights to publish and/or market the work. The agreement states important details such as whether the rights are exclusive or non-exclusive, the permitted formats of use or reproduction, the payment of royalties, and the duration of the agreement.

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Author's Information:

Full Name (e.g. Mary Janet White):

Address:

City:

Country:

State:

Province:

Zip Code:

Author's Work:

Title of Work (e.g. The Two Dogs):

Examples of categories are fiction, poetry, illustration, etc.
General Category:

Publisher Information:

Name:

Address:

City:

Country:

State:

Province:

Zip Code:

Does the Publisher have a specific area of focus (e.g. children's books)?
 Yes No

What is the Publisher's specialty?

Is the Publisher a company?
 Yes No

Name of Signor:

Title of Signor:

Nature of Rights:

Will the Publisher be granted exclusive rights?
 Yes No

Will the Publisher be putting the Author's name on the work?
 Yes No

Duration of Agreement:

This agreement will be valid:

Start Date (e.g. January 1st, 2006):

End Date (e.g. December 31st, 2008):

Geographic Limitations:

Are there geographic limits to the Publisher's rights?
 Yes No

Where is the work ALLOWED to be distributed (e.g. United States, Toronto, Canada etc.)?


Permitted Formats:

This agreement shall apply to renderings of the Work in:

Choose all formats that ARE permitted:

Print
 Yes No

Webpage/Online Publishing
 Yes No

CD or DVD
 Yes No

Radio Excerpts
 Yes No

Televised Excerpts/Footage
 Yes No

Royalty Payments:

Do you wish to state whether or not the Author will receive royalties?
 Yes No

Will the Author receive royalties?
 Yes No

Royalty Formula:

Will there be an initial lump payment?
 Yes No

Enter the amount, in dollars (e.g. 20,000.00):

Will there be a payment per sale?
 Yes No

Will the payment differ for different media formats?
 Yes No

Enter the percentage of list price (e.g. 5.0):

Select all applicable formats:

Hard Cover Book
 Yes No

Enter the percentage of list price (e.g. 5.0):

Soft Cover Book
 Yes No

Enter the percentage of list price (e.g. 5.0):

Downloadable (Electronic) Book
 Yes No

Enter the percentage of list price (e.g. 5.0):

CD and DVD
 Yes No

Enter the percentage of list price (e.g. 5.0):

Radio Excerpts
 Yes No

Enter the percentage of list price (e.g. 5.0):

Televised Excerpts/Footage
 Yes No

Enter the percentage of list price (e.g. 5.0):

Other Royalties
 Yes No

Enter the percentage of list price (e.g. 5.0):

Expenses:

Will expenses be subtracted from the royalty percentage(s) above?
 Yes No

Sales Tracking and Payment:

For royalty calculations, sales reports will be available:

Enter the frequency (e.g. annually):

Royalty statements based on these reports will be provided:

Statement method (e.g. orally):

Royalties will be paid:

Enter payment frequency (e.g. annually):

Payment will be made on (e.g. the first of each month):

Select the method of payment:

Method of payment:

Additional Clauses:

Do you wish to add any additional clauses?
 Yes No

How many additional clauses do you wish to add?

First extra clause:


Second extra clause:


Third extra clause:


Fourth extra clause:


Fifth extra clause:


Termination:

Does the Author want to be able to terminate this Agreement if the Publisher doesn't distribute the Work?
 Yes No

How many years will the Publisher be allowed (e.g. 2)?

Does the Author want to be able to terminate this Agreement if the Publisher breaches it?
 Yes No

Does the Publisher want to be able to terminate this Agreement if the Author breaches it?
 Yes No

How many days notice is required for either party to terminate the agreement without cause? (e.g. 60)

Signatures Required:

To ensure the validity of this document, we recommend the presence of a notary public and at least one witness.
Will a notary public be present?
 Yes No

Country of Signing:

State:

Province:

How many witnesses will be present?

Date of Signing:

Day (e.g. 15):

Month (e.g. April):

Year (e.g. 2006):