Documentary Footage Clearance Form
Project/Documentary Title
Date
Production Company
Producer/Contact Name
Email
Phone
Footage Details
Clip Title/Description
Timecode In
Timecode Out
Duration
Location
Purpose/Context of Use
Rights/Permissions Requested
Media
Territory
Term/Duration
Any Restrictions or Special Conditions
Clearance Notes/Approval
Applicant Signature
Name & Date
Reviewer Signature
Name & Date