Content Authorisation Form

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Name

First

Last

Name of the copyright owner

This may be your full name or the name of the organisation for which you are the authorised representative.

Please provide a valid email address that can be used to contact you. This may be a professional or business email address.

Confirm your email address

Postal address

Your phone number

Your relationship to the copyright owner

I am the copyright owner
I am the legal counsel to the copyright owner
I am an employee of the copyright owner
I am an authorized agent of the copyright owner
I am an employee of a CMO, PRO or other collective rights organisation

Electronic signature

Your electronic signature should match your full name.

Evidence of rights and authorization. Please select how you would like to send us evidence of the copyright ownership.

Email
Post

You must provide Bloc with evidence that you are either the copyright owner or are authorised to make this request on behalf of the copyright owner. Bloc reserves the right to decline your request if you don’t provide this evidence. Acceptable evidence may include a registration certificate, a licence agreement, a power of attorney, a signed letter with your organisation’s letterhead and / or other relevant materials, documents or statements that demonstrate that you are the copyright owner or have been authorised by the copyright owner to make this request. If you do not have these documents, then you can provide a signed statement via email defining your relationship to the copyright owner.

How many individual pieces of content would you like to authorise?

In order to process your request, Bloc will need to collect and store the above information. Any personal data you provide will be processed in accordance with our Privacy Policy.