Please Use Black Ink When Filling Out This Form.
PIRACY REPORT
DATA COLLECTION
*DATE:
DATA COLLECTION
*DATE:
Please Use Black Ink When Filling Out This Form. |
PIRACY REPORT DATA COLLECTION *DATE: |
| INFORMANT: |
| *Name: *Address: *Phone: Email: |
_________________________________________________________ _________________________________________________________ _________________________________________________________ _______________________ _______________________ |
| *Required
Information:
Please be advised that false witness
may result in charges being filed against you. |
| VIOLATOR: |
| *Name: *Address: *Phone: Email: *D.B.A. *Location of Violation: *Location Phone: Owner/Manager Name: *Address: Dates/Times |
_________________________________________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ _______________________ _________________________________________________________ _________________________________________________________ _______________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ |
|
*Have you been to the Show?______________ *Whose music is the host using?___________________________________________ How do you know the brand of music?______________________________________ How many rigs/set-ups does this host own or operate?_________________________ Details/Comments: |
For
internal use only!
Date:______________________________ By:___________________________________ |