FORMULARIO DE SOLICITUD DE PERMISO ÚNICO DATA OF THE PRODUCER Application No. Type of producer Judicial Person Physical Person Reg. No. SIRECINE Data of a Judicial Person Corporate name or title: RNC Number: SPUR Names and surnames of the legal representative: Type document CED PAS Number: Data of a Physical Person Names and surnames: (Cédula) Number: DATA FOR CORRESPONDENCE Mailing address: Telephone: Fax: Mobile: E-mail: Web Site: City: Province: DATA OF THE MOVIE Title of the movie: Mark with an (x) or complete the following information Short Duration (min:sec) Genre Medium Length Shooting format(s) Date shooting begins D M A Feature Length Exhibition format Final shooting date D M A Production* Names of the other national producers and/or foreign co-producers: Co-production** Filming locations: Total cost of the movie in Dominican pesos: SIGNATURE (of the producer or the legal representative of the producer company)
City and date WITH MY SIGNATURE I CERTIFY THE VERACITY OF EVERYTHING CONSIGNED IN THIS FORM AND ITS RESPECTIVE ATTACHMENTS.
DOCUMENTS REQUIRED 1. Application letter and/or application form for the Sole Shooting Permit, signed by the producer or legal representative. 2. Copy of the identification document of the producer of the work or their legal representative. 3. Certificate of Registration of the producer or executive producer with the National Registry of Cinematic Agents of SIRECINE, issued by DGCINE. 4. Copy of the script, with corroboration of its registration with the National Office of Copyrights (Oficina Nacional de Derechos de Autor - ONDA) 5. Document that justifies the rights of the producer to the work to be carried out with respect to the script, the music or any other copyright which may come into play in the production. 6. Kind of Audiovisual or Cinematic Work. 7. Account of the artistic, technical and creative personnel selected at the time of the application. 8. Shooting plan, including duration, dates and locations 9. Budget of the project 10. Insurance policy for civil liability for damages to third parties. 11. Tax or promotional incentives by Law to those applicable. The sole shooting permit can be processed simultaneously with the provisional certificate of Dominican Nationality. If this is so, the file for the Provisional Certificate will have the following requisites attached: a) Letter of application and/or application form for the Sole Shooting Permit b) Insurance police for civil liability to third parties.
REGISTRATION OF TECHNICAL AND ARTISTIC PERSONNEL (FEATURE LENGTHS) Register only Dominican citizens, or foreigners resident in the Dominican Republic. When there is more than one person in charge, please process the information for each one independently. Name Director: Name Script Writer Name Director of Photography: Name Art Director: Name Music Composer: Name Editor/Montajista: Name Camera Operator: Name Makeup Artist: Name Costume Designer:
Name Ambiance Person: Name Head of Casting: Name Script: Name Sound Person: Name Mixer: MFCS/AUGUST.11.DGCINE.FORMATO DE PERMISO UNICO. English.