Applicants should be familiar with the Low Budget Independent by qfc86623

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									                                                                                                           For Telefilm Canada use
                             Low Budget Independent Feature                                                Application #
                                                                                                           Date Received:
                             Film Assistance Program                                                                              Y                M            D
                             Application Form
                                                                                                                                                        Page 1 of 6

                                                       Did you know you can apply online using eTelefilm?
           It’s fast, secure and user-friendly! Benefits for this program include direct deposit and more! Give it a try: http://www.telefilm.gc.ca/eTelefilm

Applicants should be familiar with the Low Budget Independent Feature Film Assistance Program (LBIFFAP) guidelines and
the applicable Telefilm Canada business policies prior to completing this application form. Please complete all information
requested and include all relevant documentation with your application. Please note that this application form must be
signed by all applicants prior to submission to Telefilm Canada.

THIS APPLICATION IS A REQUEST FOR:                                     ENGLISH-LANGUAGE PROJECT:                     FRENCH-LANGUAGE PROJECT:
                                                                         Production financing                          Production financing
                                                                         Post Production financing                     Post production financing

CURRENT TITLE OF PROJECT                                                            PREVIOUS TITLE(S) OF PROJECT


ISAN NUMBER (IF APPLICABLE; 26 DIGITS):
IS THIS PRODUCTION AN OFFICIAL INTERNATIONAL TREATY COPRODUCTION?                                                         Yes                                   No
If yes, is an application already submitted to the Telefilm Co-production office for a Preliminary Ruling?                Yes                                   No
HAS THIS PROJECT EVER BEEN SUBMITTED TO TELEFILM CANADA (INCLUDING THE SLATE DEVELOPMENT PROGRAM) OR CTF?                 Yes                                   No
If it received funding, please provide the following information:
       AMOUNT                           DATE OF CONTRACT                AT WHAT STAGE?                     APPLICATION NUMBER
       $
                                      Y                    M            D

NAME OF APPLICANT (DIRECTOR)


LEGAL NAME OF PRODUCTION COMPANY (AS APPLICABLE)                                    LEGAL NAME OF CO-PRODUCTION COMPANY(IES) (AS APPLICABLE)


ADDRESS                                                                             ADDRESS


CITY                     PROVINCE                              POSTAL CODE          City                   PROVINCE          COUNTRY               POSTAL CODE

TELEPHONE                             FAX                                           TELEPHONE                                FAX
(          )        -                 (       )        -                            (      )        -                        (        )        -
E-MAIL FOR OFFICIAL                                                                 E-MAIL FOR OFFICIAL
NOTIFICATIONS                                                                       NOTIFICATIONS
WEB ADDRESS                                                                         WEB ADDRESS
CONTACT FOR THIS FILE

FOR FRENCH-LANGUAGE PROJECTS ONLY: THE ELIGIBLE APPLICANT HAS DIRECTED AND COMPLETED AT LEAST ONE INDEPENDENT SHORT DRAMA NON-
STUDENT FILM THAT WAS PUBLICALLY AND PROFESSIONALLY SCREENED OR BROADCASTED IN CANADA (SEE ANNEX II IN THE GUIDELINES):
TITLE OF COMPLETED FILM:                             DURATION OF FILM:  FESTIVAL / BROADCASTER:            EXHIBITION DATE/AIR DATE:
                                                                            mins.

FOR ENGLISH-LANGUAGE PRODUCTION PROJECT ONLY:
THE APPLICANT DIRECTOR HAS DIRECTED AND COMPLETED (SELECT ONE AND IDENTIFY QUALIFYING PRODUCTION(S)):
     AT LEAST TWO INDEPENDENT SHORT DRAMA NON-STUDENT FILMS THAT HAVE BEEN SELECTED FOR PRESENTATION AT A MINIMUM OF ONE OF THE
     RECOGNIZED FESTIVALS (LISTED IN ANNEX II IN THE GUIDELINES):
     AT LEAST ONE INDEPENDENT SHORT DRAMA NON-STUDENT FILM THAT HAS WON A RECOGNIZED AWARD LISTED IN A RECOGNIZED FESTIVAL (LISTED IN ANNEX
     II IN THE GUIDELINES):
     AT LEAST ONE SHORT FICTION PROGRAM OR NON-FICTION PROGRAM, OF AT LEAST 30 MINUTES IN DURATION, AIRE ON A CRTC LICENSED TELEVISION
     BROADCASTER (PAY, SPECIALITY OR CONVENTIONAL BROADCASTER):
TITLE OF COMPLETED FILM:                   DURATION OF FILM:      FESTIVAL/BROADCASTER:      EXHIBITION/AIR DATE:   AWARD:
                                                               mins.
                                                               mins.




                                                                                                                                                          TFC0810
Low Budget Independent Feature Film Assistance Program
Application Form
                                                                                                                                             Page 2 of 6


 SYNOPSIS (100 WORDS OR LESS)




IF THE SCREENPLAY IS BASED ON AN ORIGINAL WORK:
TITLE OF ORIGINAL WORK:                AUTHOR:                                   MEDIUM (I.E. BOOK, STAGE PLAY…):        CITIZENSHIP OF AUTHOR



1. GENRE (SELECT ONLY ONE):                       2. TARGET AUDIENCE:                    5. LANGUAGE:          ORIGINAL VERSION      DUBBED VERSION
     Action/Adventure                                  Children                          English
      Animation                                         Youth                            French
      Comedy                                            General                          Double Shooting                                      --
      Romantic Comedy                                                                    Other (specify)
      Drama
      Historical Drama                            3. PROPOSED DURATION:                  6. SHOOTING REGION(S) / LOCATION(S)
      Horror/Thriller                                     minutes
      Mystery/Crime/Police
      Musical                                     4. PRODUCTION TYPE (TECHNIQUE):        7. PROPOSED:          SHOOTING MEDIUM       DELIVERY MEDIUM
      Science Fiction/Fantasy/Tale                      Live Action (Conventional)                                 (FORMAT)                (FORMAT)
      Western                                           Animation:                       Film:                       mm
                                                                % animation content      Video:                      (specify)             (specify)

CULTURAL CONTENT         Cultural content refers to content only – NOT production personnel
(CHECK ONLY ONE):        (Note: this information is gathered for statistical purposes only)
    Aboriginal           Must be PRIMARILY about aboriginal characters or issues.
    Multicultural        Must be PRIMARILY about visible minority characters or issues OR characters or issues based on first generation
                         immigrants to Canada from Eastern Europe or Latin America.
     General             All other projects.

PRODUCTION SCHEDULE                                             PROJECTED DATE
First day of principal photography
Last day of principal photography                                                                 Number of shooting days:          days
Date of completion of rough cut
Date of completion of fine cut
Delivery date
Date of completion of final costs/audit
                                                    Y                   M               D


PROJECT PARTICIPANTS                            LAST NAME                      FIRST NAME                  CITIZENSHIP           CONFIRMED         POINTS*
Director                                                                                                                             X
Producer                                                                                                                                            N/A
Co-producer                                                                                                                                         N/A
Executive producer                                                                                                                                  N/A
Other producer(s)                                                                                                                                   N/A
Production manager                                                                                                                                  N/A
Scriptwriter(s)
Script editor                                                                                                                                       N/A
Story Consultant                                                                                                                                    N/A
Editor/Offline Editor
Music composer




                                                                                                                                               TFC0810
Low Budget Independent Feature Film Assistance Program
Application Form
                                                                                                                                            Page 3 of 6


PROJECT PARTICIPANTS                            LAST NAME                     FIRST NAME                 CITIZENSHIP            CONFIRMED      POINTS*
LIVE ACTION
D.O.P./Technical/Lighting Director
Production Designer/Art director
ANIMATED
Storyboard Supervisor
Design Supervisor/Art Director
Camera Operator & Op. Location(s)
Layout & Background Location(s)
Key Animation Location(s)
Asst Animation & Inbetweening Location(s)
1st or 2nd Highest Paid Voice
*Expected points using the CAVCO scale. The Low Budget Independent Feature Film Assistance Program will be using the CAVCO Canadian Content
point system as a guideline. A project must attain a minimum 8/10 points in order to be eligible for consideration.

LEADING PERFORMERS               ROLE                 LAST NAME                  FIRST NAME              CITIZENSHIP            CONFIRMED      POINTS*
Highest Paid Performer
2nd Highest Paid Performer
Other Principal Cast                                                                                                                               N/A
Other Principal Cast                                                                                                                               N/A
Other Principal Cast                                                                                                                               N/A
Other Principal Cast                                                                                                                   N/A
*Expected points using the CAVCO scale. The Low Budget Independent Feature Film Assistance Program will be using the CAVCO Canadian Content
point system as a guideline. A project must attain a minimum 8/10 points in order to be eligible for consideration.

FINANCING FOR THIS PHASE                                                   TYPE OF FINANCING         AMOUNT             % OF      PENDING    CONFIRMED
(SPECIFY LEGAL NAME OF SOURCE(S); ADD LINES AS NEEDED)                                                                 BUDGET

Telefilm Canada                                                            Advance                       $                  %        X             -
                                                                                                         $                  %
                                                                                                         $                  %
                                                                                                         $                  %
                                                                                                         $                  %
                                                                                                         $                  %
                                                                                                         $                  %
Total financing                                                                                          $             100%

BUDGET                                                                                            TOTAL BUDGET (CDN COSTS)                    $
DATE OF SUBMITTED BUDGET:                                                                      TOTAL BUDGET (FOREIGN COSTS)                   $
                                       Y            M              D                                           TOTAL BUDGET*                  $
*Minimum eligible total budget is $250,000, and maximum eligible total budget is $1,250,000 for the English market and $1,500,000 for the French
market.




                                                                                                                                             TFC0810
Low Budget Independent Feature Film Assistance Program
Application Form
                                                                                                                                  Page 4 of 6

                                              REQUIRED DOCUMENTS CHECKLIST
At the time of application, together with this completed application form, the applicant must provide all of the documentation
listed below. Please be advised that during the review of your project, the applicant may be required to provide additional
documentation or information. Telefilm Canada reserves the right to request any document or information it deems relevant,
including, but not limited to, any document or information pertinent to the eligibility of the applicant and the project.

Please be advised that Telefilm Canada will not act as a depositary or be responsible in any way for the holding or return of
any material submitted at any time in connection with the application or the project and such material may be destroyed at
any time.

                                                                                                                                  FOR TFC
                                                                                                                     ENCLOSED
                                                                                                                                  USE ONLY
1.   Application form (duly completed and signed)
2.   For Production request: Screenplay (dated) and one page synopsis – 5 copies
     For Post production request: Screenplay (dated) and one page synopsis – 2 copies
     Note : In addition to the paper copies, please send a copy of the creative material in PDF format if you can.

3.   For Production request: Director’s vision and intentions for the film – 5 copies
     For Post production request: Director’s vision and intentions to complete the film – 2 copies
     Note : In addition to the paper copies, please send a copy of the creative material in PDF format if you can.

4.   For Post production request only: DVD or VHS copies of the most recent cut of the production** – 2                (N/A   )
     copies
     ** All Post production requests must be submitted prior to final cut and be a minimum of 75 minutes in
     duration
5.   Original literary work (as applicable) – 2 copies                                                                 (N/A   )

6.   Proof of festival participation or award nominations
     (An affidavit or copy of the festival or award program for the film is required)
7.   CV’s of all key creative personnel including director, writer(s) and producer(s) (as applicable).
8.   DVD or VHS copy of the Director’s most recent short or feature length dramatic work – 1 copy
9.   Producer agreement(s) (if applicable)                                                                             (N/A   )

10. All financing agreements from committed sources evidencing the terms, conditions and value of the
    financial contributions and/or copies of applications submitted to potential financing partners, with the
    status of each request.
    (see CFFF Budgets & Production Financing Requirements policy)
11. For Production request: Preliminary marketing and distribution plan (optional, but strongly                        (N/A   )
    recommended, when a Distributor is attached)
    For Post production request: Preliminary marketing and distribution plan (optional, but strongly
    recommended)
12. A Canadian theatrical distribution Letter of Interest (if available; however, required for French-                 (N/A   )
    Language projects with a production budget over $1 million) / a Canadian broadcast letter of interest (if
    available) festival & other letter(s) of interest.
13. For Production request: Production budget in standard Telefilm Canada format*, dated and signed by the
    director
    For Post production request: A copy of the detailed cost report/budget (dated & signed by the director)
    accounting for work done to date (with separate columns for paid and payable – indicating cash costs and
    deferrals) and budgeted cost to complete – all totalling the overall cost to complete and deliver the
    production

     (For international treaty co-productions, provide a multi-column budget showing each country’s
     participation in a separate column and a consolidated total column.)
     (see CFFF Budgets & Production Financing Requirements policy)




                                                                                                                                   TFC0810
Low Budget Independent Feature Film Assistance Program
Application Form
                                                                                                                                                  Page 5 of 6


                                                                                                                                                  FOR TFC
                                                                                                                                   ENCLOSED
                                                                                                                                                  USE ONLY
14. Cash flow and federal and provincial tax credit calculations
15. Production and post-production schedule, including:
       pre-production start date;
       date and number of shooting days (including commencement and completion of principal photography
        dates);
       all shooting locations(city and country);
       projected dates for rough cut, fine cut, delivery and final audited cost report.
16. Clean and complete chain of title including:
        a complete description of the development history of the project;
        copy of screenwriter(s) transfer of rights contract or option agreement including payment schedule (if
         applicable);
        all documentation demonstrating applicant(s) has the rights to the concept and underlying creative
         material and holds the rights to produce, distribute and exploit the project.
    In the case of an adaptation of an existing work:
        a copy of the agreement for the assignment of underlying literary rights;
        a publisher’s release (where applicable).


17. The following documents are required if they have been updated or modified since the                                           ON FILE AT     FOR TFC
                                                                                                                     ENCLOSED
    production company’s last funding application to Telefilm Canada:                                                                TFC          USE ONLY
     Incorporation documents for applicant production company(ies) and parent company(ies), if
      applicable, with list of shareholders indicating citizenship and ownership share
     Corporate financial statements for the past three fiscal years
                                                                      1

     Shareholder or partner’s agreement (as applicable)
     Canadian Status of Corporation and Corporate Information Affidavit (form available on TFC
      website)


       If the applicant is not incorporated at the time of applying and if the application is in turn
       successful, the applicant shall incorporate and submit to Telefilm Canada all above
       documents required prior to execution of a contract with Telefilm Canada. All reasonable fees
       related to incorporation may be included in the production budget.


Please be advised that the successful applicant will be required during contracting to provide Telefilm Canada with:
       Proof of full financing (to include deferral* and investment agreements)
       Canadian citizenship affidavits
       A signed Director Ownership affidavit*
       E&O Insurance (without any exclusion including title and music)
       Cost reports during production and post-production (as agreed to with TFC)
       Final review engagement report or audited final cost report
       A copy of the receipt issued by the National Archives of Canada for preservation material as stipulated in the Guidelines.

*Sample forms available




1
    The applicant must provide for the last three fiscal years:
       (a) consolidated and audited annual financial statements, if consolidated annual gross revenue of the applicant and its related parties is equal to
            or greater than $10 million;
       (b) consolidated annual financial statements, together with a review engagement report if consolidated annual gross revenue of applicant and its
            related parties is equal to or greater than $5 million but less than $10 million;
       (c) non-consolidated annual financial statements, together with a notice to readers if consolidated annual gross revenue of the applicant and its
            related parties is less than $5 million.
     Notwithstanding the foregoing, Telefilm reserves the right to request from the applicant, at any time and at Telefilm’s absolute discretion, consolidated
     and audited annual financial statements.


                                                                                                                                                    TFC0810
Low Budget Independent Feature Film Assistance Program
Application Form
                                                                                                                                 Page 6 of 6

                            TELEFILM CANADA IS SUBJECT TO THE ACCESS TO INFORMATION ACT.

                                                       APPLICANT STATEMENTS:

The undersigned authorized representative of the applicant and co-applicant (if applicable) hereby:

        authorizes Telefilm Canada to discuss and disclose any information concerning any aspect of the funding application, the
         project, any previously completed project, the applicant and any related party to the applicant, with every entity connected (in
         Telefilm’s opinion) with the funding application, the project, any previously completed project, the applicant and any related
         party to the applicant, including, but not limited to, actual or proposed financial partners, corporate and/or completion
         guarantors, interim financiers, auditors, legal counsels, the Canada Media Fund, the Department of Canadian Heritage,
         CAVCO, CRTC, and other governmental entities (collectively the “Entities”). The applicant further authorizes said Entities to
         discuss and disclose to Telefilm any information concerning any aspect of the funding application, the project, any previously
         completed project, the applicant and any related party to the applicant,

        authorizes Telefilm Canada to disclose on its website any and all information pertaining to the application and/or project, such
         as the project title, synopsis, genre and format, writing language and production companies;
        agrees to notify Telefilm Canada immediately if and when any changes occur to any of the submitted documents and shall
         provide written details of same;
        declares that applicant(s) has(/have) not entered into any oral or written agreement or side deal that conflicts with any of the
         provisions of this application form, of the LBIFFAP guidelines and applicable Telefilm Canada business policies;
        declares that the project complies and will continue to comply with the LBIFFAP guidelines and applicable Telefilm Canada
         business policies;
        has made and shall make without delay full disclosure to Telefilm Canada of any dispute, and actual or potential litigation in
         connection with the project;
        declares that all persons specified as being Canadian in the application and all accompanying documentation, are Canadians,
         in accordance with the Investment Canada Act, the Immigration and Refugee Protection Act or the Citizenship Act;
        authorizes Telefilm Canada to reproduce and distribute internally to its employees and subcontractors, all material submitted
         at any time in connection with the project, using any medium or support including its internal servers.

The undersigned hereby declares and warrants that the information and documents submitted for this application are
accurate, true and complete, and makes this solemn declaration knowing that it is of the same force and effect as if made
under oath.

Signature of Applicant:

                                     I am duly authorized


                                     (Please print )
Title:


                                                                    Date:
                                                                                   Y                    M                    D

Signature of Co-Applicant:
(as applicable)
                                     I am duly authorized


                                     (Please print )
Title:


                                                                    Date:
                                                                                   Y                    M                    D




                                                                                                                                  TFC0810
                                                                      TFC0810

								
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