Application for a provisional certificate for a film as a qualifying Australian film
APPLICATION
1. Film working title Type of film ( one only) Film of like nature (to a feature film) Feature film produced for exhibition by way of television Documentary Telephone no. What is ESTIMATED TOTAL BUDGET for the film? $ Mini series of television drama Fax no.
2. Full name of applicant (individual/company) Applicant’s address
What is the applicant’s role in the production of the film? Telephone no. Telephone no.
Contact officer (if not applicant)
3. Name of production entity Business address of production entity Postal address (if different)
Telephone no.
Fax no.
ELIGIBLE FILM
4 What is the total length and gauge of the proposed film? FILM OR 16mm 35mm Other Length minutes
VIDEO - Specify type:
Length minutes
5 Does or will the film have an Australian Broadcasting Authority (ABA) provisional ‘C’ classification and/or is it specifically designed for children under six years of age? NO YES
-26 If the film is a DOCUMENTARY OF A NUMBER OF PARTS: What is the title of each part?
What is the NUMBER of parts and LENGTH of each in minutes? x minutes
What is the COMMON THEME between the parts if any?
7 If the film is a MINI SERIES OF A TELEVISION DRAMA what is the NUMBER of episodes and LENGTH of each in minutes?
8 What are your INTENTIONS CONCERNING EXHIBITION of the film in cinemas or by way of television broadcasting? Attach supporting documentation from exhibitions/distributors if available.
9 Will the principal purpose of the film or any part of the film be the PROMOTION in any way of a product or service or the image and reputation of a business, institution, organisation or group? NO YES - if YES, outline the promotional aspect.
-310 Will the film or any part of the film be SPONSORED OR COMMISSIONED by any business, institution, organisation or group? NO YES - if YES, outline details including name of organisation etc.
11 Will the film contain any RECORD OF A PUBLIC EVENT, in whole or in part, including sporting activity, theatrical performance, artistic performance or any other activity, performance or event? NO event(s). YES - if YES, describe the public event(s) and indicate the percentage of principal photography represented by the
%
AUSTRALIAN FILM
12 Briefly describe the subject matter of the proposed film.
13 For drama programs list the nationality of PRINCIPAL CHARACTERS portrayed in the script (this does not refer to the cast). Character Portrayed Nationality Character Portrayed Nationality
14 Will there be any NON-AUSTRALIAN SETTINGS in the script (this does not refer to the location for shooting)? NO YES - if YES, what percentage of the film will be set outside Australia and describe the settings.
-415 Who is the SCRIPTWRITER? Name Nationality
Place of residence for last two years (from date of application) if NOT Australia. Country Period and dates of residency
16 Is the script/treatment based on source material eg novel, short-story, play, existing script or research material OTHER THAN THE WORK OF THE SCRIPTWRITER NAMED IN Question 15 above? NO YES - if YES, attach a copy of the material and state: Author’s name Nationality
Title of existing source material
Place of residence for last two years (from date of application) if NOT Australia. Country Periods and dates of residency
17 Has any NON-AUSTRALIAN PERSON contributed directly to the development of the script or treatment? NO Name YES - if YES, state contributor's details as follows: Nationality
Place of residence for last two years (from date of application) if NOT Australia. Country Periods and dates of residency
Nature of contribution
18 Is any non-Australian person/entity and/or non-Australian resident or their agent or associate entitled to receive, or has received, any PAYMENT IN CONNECTION WITH THE ACQUISITION, DEVELOPMENT OR EXPLOITATION OF THE CONCEPT FOR THE FILM OR ITS SCRIPT/TREATMENT? NO YES - if YES, state the details of this person or entity as follows:
Name
Nationality
Place of residency for last two years (from date of application) if not Australia Country Periods and dates of residency
-5AMOUNT of payment made or to be made and PURPOSE of payment.
Purpose Attach a copy of any relevant agreement
19 Will ANY STAGE OF THE PRODUCTION of the film, including rushes processing, take place outside Australia? NO YES - if YES, complete the following table noting the number of weeks spent outside Australia in any production stage. Total projected duration in weeks Weeks outside Australia Location outside Australia
Production stage Research and development Pre-production Principal photography Post production TOTAL
20 If any stage of the production of the film is to take place outside Australia give reasons for this.
21 If any processing of the rushes of the film is to take place outside Australia give reasons for this and the location of processing.
22 Complete the CAST LIST attached at SCHEDULE 1. 23 Complete the CREW LIST attached at SCHEDULE 2. 24 Type of Production entity. Person Company Partnership Other - (describe below)
25 Where the production entity is a COMPANY complete SCHEDULE '3'. 26 Where the production entity is a PARTNERSHIP complete SCHEDULE '4'. 27 Who are, or will be, THE BENEFICIAL OWNERS OF THE COPYRIGHT in the film? Copyright owners Nationality Place of residence
28 If copyright owners are not known, is ANY NON-AUSTRALIAN OWNERSHIP to be considered?
-6NO YES - if YES, give relevant details
29 Give all SOURCES OF FUNDS, both Australian and non-Australian, to be used in making the film, INCLUDING GRANTS, INVESTMENTS, LOANS AND GUARANTEES. State if there is any State and Commonwealth Government assistance. Source of funds Type of support Amount $
TOTAL BUDGET 30 If sources of funds other than Australian investors are not known, have any non-Australian persons or entities been approached or are to be considered as contributors to the funding of the film? NO YES - if YES, give details.
31 Will there be any NON-CASH CONTRIBUTIONS to the making of the film e.g. use of studios, air tickets, use of facilities, deferred payments etc? NO YES - if YES, list and describe contributions by non-Australian persons/entities and also Australian persons/entities.
32 Will any part of the budget be spent outside Australia, including financial settlements made in Australia for services provided outside Australia, or be used to meet the cost of NON-AUSTRALIAN ELEMENTS in the film? (e.g. payments to non-Australian scriptwriters, cast or crew, overseas travel, internal travel in foreign countries, accommodation, purchase of story and film rights and completion guarantees)? NO Budget Item YES - if YES, complete the table. Amount $ Country of expenditure
TOTAL OVERSEAS EXPENDITURE 33 What is the percentage of overseas expenditure to the total budget? %
-734 Will any non-Australian person/entity and/or non-Australian resident or their agent or associate (including scriptwriters, cast or crew) share in the profit of the film or its related rights? NO YES - if YES, complete the table. Nationality and place of residence/incorporation Details of profit share
Name of person/entity
35 Will any non-Australian person/entity and/or non-Australian resident or their agent or associate other than persons listed as Crew Members, in Schedule 2 HAVE ANY RIGHTS, including the right to be consulted, to veto, or to give approval with respect to the script, cast and crew, music and edit mix, budget items, copyright in the film or its exploitation? This includes any such rights under distribution agreements. NO YES - if YES, give details of such rights and attach copies of any relevant agreements. (Signed copies of agreements should be provided as soon as practicable).
36 Where RIGHTS ARE OR WILL BE GIVEN in Question 35 a non-Australian person/entity and/or non-Australian resident or their agent or associate, state: Name Nationality
Place of residence for last two years (from date of application) if not Australia. Country Periods and dates of residency
ATTACHMENTS CHECKLIST if attached ESSENTIAL Justification for non-Australian elements Description of Australian perspective for documentaries shot outside Australia Treatment for documentaries Script or synopsis WITH reasons for unavailability of script for drama programs Full budget for budget summary POSSIBLE Applicants should attach ANY FURTHER INFORMATION that could be regarded as relevant to the Minister when determining if the film is a 'Qualifying Australian Film'.
Documentation at Question 8 Copy of source material at Question 16 Agreement at Question 18
-8Agreement at Question 35 Agreements at Schedule 1 Agreements at Schedule 2 APPLICANT’S SIGNATURE I HEREBY apply to the Minister for a Provisional Certificate for the purposes of Division 10 BA of Part III of the Income Tax Assessment Act 1936. Applicant’s signature Date
WARNING: Under section 29B of the Crimes Act 1914 (Commonwealth) it is an offence to impose or endeavour to impose upon the Commonwealth by any untrue representation, made in any manner whatsoever, with a view to obtaining money or any other benefit or advantage. PENALTY: Imprisonment for two years. Are you a for profit small business (employing fewer than twenty employees)?: Yes/No If yes: Please provide an estimate of the time taken to complete this form. Include: the time taken working on the question and obtaining the information; and the time spent by all employees in collecting and providing this information. hrs mins
Please mail to:
Australian Film Industry Section Department of Communications, Information Technology & the Arts GPO Box 2154 CANBERRA ACT 2601
Street Address: Australian Film Industry Section Department of Communications, Information Technology & the Arts 38 Sydney Ave FORREST ACT 2603
-9SCHEDULE 1—DETAILS OF SELECTED/PROPOSED CAST MEMBERS (Question 22 refers) (Identify principal cast by letter 'P' after the name) - Note: In case of animated films cast includes voices. Name Nationality Place(s) of residence for last two years (from date of application) if NOT Australia Character portrayed
If cast members unknown will they be Australian? YES/NO For a cast member (selected or proposed) who is NOT an Australian citizen AND whose habitual place of residence and work for the last two years (from date of application) has NOT been Australia, give reasons for the choice of that person. Attach copies of agreements, if available.
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SCHEDULE 2—DETAILS OF SELECTED/PROPOSED CREW MEMBERS (Question 23 refers) Position Producer(s)* Name Nationality
Associate Producer Executive Producer Director* Director of Photography Composer Musical Director Art Director Production Designer Editor Sound Mixer Narrator* Presenter* Cameramen* Sound Recordist
Other Script Editor Story Editor If crew members are unknown will they be Australian? YES YES/NO
* NOTE Identification is essential for documentary films to be shot outside Australia. For a crew member (selected or proposed) who is NOT an Australian citizen AND whose habitual place of residence and work for the last two years (from date of application) has NOT been Australia, give reasons for the choice of that person. Attach copies of agreements, if available.
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SCHEDULE 3—THE PRODUCTION ENTITY, IF A COMPANY OR PROPOSED COMPANY (Question 25 refers) NOTE: If the beneficial owner of the Production Entity is a Public Company, only non-Australian beneficial ownership need be specified. Beneficial owners of shares in the company Nationality Place(s) of residence for last two years (from date of application) if not Australia % beneficial interest in the company (specify voting power of any non-Australian interest)
SCHEDULE 4 - THE PRODUCTION ENTITY IS A PARTNERSHIP (Question 26 refers) Name of partners Nationality Place(s) of residence for last two years (from date of application) if not Australia Number of shares/units in partnership and % profit to which entitled