Free Spirit Publishing Royalty Statement Template Please fill out the Royalty Statement and email to Sara Hartman-Seeskin at email@example.com or fax to 1 612 337 5050. Please complete a Statement for each title. NOTE: Report must be completed in English using U.S. Dollars (USD). If you have questions please contact Sara Hartman-Seeskin at firstname.lastname@example.org. Please fill in this column Date: Publisher: Title: Proprietor: Free Spirit Publishing Publication date: Reporting period: Total copies printed: Copies sold before this period: Statement/Sales Period: Number of copies printed this period: Number of copies sold in this period: Number of gratis copies: Number of copies remaining in stock: Advance amount (USD): Previous balance against advance (USD): Unit/Retail price (USD): Revenue from copies sold this period (USD): Royalty rate/percent (%): Royalties due (USD): Payment type (check or wire transfer): Date payment expected: PLEASE NOTE: For bank account details please contact Sara Hartman-Seeskin at email@example.com. All wire transfer fees are the responsibility of the sender.
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