Enter the song title you wish to license
F u l l  C i r c l e  M u s i c  G r o u p
WHAT CONFIGURATION(S)? Please check all that apply.
Compact Disc
Cassette
Vinyl
DPD (Digital
Phonerecord Delivery,
aka Permanent
Download)
Mechanical licenses are required under U.S. Copyright Law if you want to record or distribute a song that you do not own. By properly licensing your
recordings, you ensure that the publisher that represents the songwriter  or the self-publishing songwriter who wrote the composition gets paid.
Reputable replicators and online music sites will require you to have these licenses before they duplicate your recording or offer it online.
Mechanical License
Mechanical License
This electronic Mechanical License Request Form Agreement encompasses both physical product ((CD, Cassette, or Vinyl LP) AND DPD (Digital
Phonerecord Delivery, aka Permanent Download)   Please fill in all the numbered blocks completely.  A seperate request form must be completed
for each song.
HOW MANY TOTAL COPIES OF THE RECORDINGS WILL
YOU MAKE (ALL FORMATS TOGETHER)?
e.g. 500 CDs, 500 Cassettes, and 500 LPs and
1500 Recordings.).
HOW MANY DOWNLOADS (PER SONG) DO YOU
EXPECT TO DISTRIBUTE IN THE NEXT 12 MONTHS?
Must be at least 25
There is a minimum requirement of 500 total units
1
3
Album Title/ Product Name - The title of your album
Label/Organization - The name of organization distributing the album
Anticipated Release Date - The date of the first distribution of your recording
If applicable, please supply UPC (bar code) and Product number information
Compact Disc (CD) UPC #
Record/Product Number
WHAT ARE THE NAMES OF THE WEBSITES THAT WILL BE OFFERING YOUR DPDS (Digital Phonerecord Delivery, aka
Permanent Download), IF KNOWN? PLEASE SEPARATE EACH SITE WITH A COMMA.
What is the current statutory mechanical
rate and how is it calculated?
Please edit the information below as necessary. The Licensee should be the label or organization (or individual) who will
be distributing the recordings.
Licensee Name
Contact First Name
Contact Last Name
Company/Organization Name
Album Title/ Product Name - The title of your album
Label/Organization - The name of organization distributing the album
Anticipated Release Date - The date of the first distribution of your recording
If applicable, please supply UPC (bar code) and Product number information
Compact Disc (CD) UPC #
Record/Product Number
WHAT ARE THE NAMES OF THE WEBSITES THAT WILL BE OFFERING YOUR DPDS (Digital Phonerecord Delivery, aka
Permanent Download), IF KNOWN? PLEASE SEPARATE EACH SITE WITH A COMMA.
4
Configurations
2
Total Copies of Recording
Release Information
Licensee Information