Canada Feature Film Fund

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					                                                                                                      For Telefilm Canada use
                          Canada Feature Film Fund                                                    Application #
                          Application for Versioning Assistance                                       Date Received:
                                                                                                                             Y             M                 D
                                                                                                                                                  Page 1 of 3

Applicants should be familiar with the Canada Feature Film Fund (CFFF) Versioning Assistance Program 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 this application form must be signed by
all applicants prior to submission to Telefilm Canada.
THIS APPLICATION IS FOR THE VERSIONING OF A FEATURE FILM FOR:                      Theatrical release         or            Television release

THIS APPLICATION IS FOR VERSIONING INTO               English                   French            or          Aboriginal:
THIS APPLICATION IS FOR                               Versioning                Minor changes to existing version (production was versioned in Canada)

ORIGINAL LANGUAGE TITLE OF PROJECT                                              VERSIONED LANGUAGE TITLE OF PROJECT


ISAN NUMBER (IF APPLICABLE; 26 DIGITS):
LEGAL NAME OF APPLICANT COMPANY                                                 ORIGINAL VERSION PRODUCTION COMPANY / COPYRIGHT OWNER


ADDRESS                                                                         ADDRESS

CITY                  PROVINCE                       POSTAL CODE                CITY                       PROVINCE                            POSTAL CODE

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

DETAILS OF PREVIOUS CFFF PRODUCTION FINANCING FOR THIS PROJECT:
AMOUNT                     DATE OF CONTRACT                                            APPLICATION NUMBER
$
                                       Y                M                   D

CANADIAN CERTIFICATION FOR ORIGINAL PRODUCTION:                CONTENT POINTS                          NUMBER                               CAVCO
                                                                                                                                            CRTC

THE APPLICANT IS A           PRODUCTION COMPANY AND PRODUCER OF THE FILM                                  DISTRIBUTION COMPANY
                          Holding the following rights:               Feature Film                        Television          New Media
                          Holding the following territories:

TECHNIQUE:              ORIGINAL VERSION:                   PROJECT GENRE (SELECT ONLY ONE):       DELIVERY FORMAT OF VERSIONED PRODUCTION:
       Animation            English                             Action/Adventure                   Film                                          mm
       Conventional         French                              Animation                          Video                                         (specify)
                            Double shooting                     Comedy
                            Other                               Romantic Comedy                    DURATION OF ORIGINAL LANGUAGE PRODUCTION:
                                                                Drama                                    mins.
TARGET AUDIENCE:        EXISTING DUBBED VERSION(S):             Historical Drama                   DURATION OF VERSIONED PRODUCTION:
       Children             French                              Horror/Thriller                          mins.
       Youth                English                             Mystery/Crime/Police               TRIGGER BROADCASTER/EXHIBITOR/FOREIGN SALES AGENT:
       General              Other                               Musical
                                                                Science Fiction/Fantasy/Tale
                                                                Western




                                                                                                                                                      TFC0210
Canada Feature Film Fund
Application for Versioning Assistance
                                                                                                                                                   Page 2 of 3



TOTAL PRODUCTION BUDGET FOR ORIGINAL LANGUAGE VERSION                                $
TOTAL VERSIONING BUDGET                                                              $
AMOUNT OF ADVANCE REQUESTED FROM TELEFILM CANADA                                     $
VERSIONING COSTS INCLUDED IN ORIGINAL LANGUAGE PRODUCTION BUDGET?                        Yes             No
ONE OR MORE OF THE PRODUCTION FINANCIERS REQUIRED THE PROJECT BE
VERSIONED INTO THIS SECOND LANGUAGE?
                                                                                         Yes             No

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.

NOTE: There is no application deadline; however, applications seeking financing assistance in the current fiscal year (April 1
– March 31), must submit a complete application prior to the December 15 closing date. Applications received after the
closing date will be assessed for assistance in the next fiscal year, provided that the Program is renewed.

                                                                                                                                                    FOR TFC
       All elements must be received at time of application.                                                                         ENCLOSED
                                                                                                                                                    USE ONLY
1.     Application form (duly completed and signed)
2.     A triggering agreement with a broadcaster / exhibitor or foreign sales agent:
        A letter of commitment from a broadcaster to air the versioned production in Canada or abroad within                           (N/A   )
           one (1) year of delivery, and must specify the broadcast license fee; or
        A letter of commitment from an exhibitor to theatrically release the versioned feature film in Canada                          (N/A   )
           within one (1) year of delivery; or
                                                                                                                                        (N/A   )
        A foreign sales agent contract.
3.     All documentation demonstrating that the applicant holds all the requisite rights to distribute the
       versioned production in the target market and can achieve the required terms of reimbursement
       (i.e. distribution and/or pre-sale agreements)
4.     Versioning budget (in standard Telefilm format; available on Telefilm website) showing breakdown of all
       anticipated costs; including quotes from the versioning company and other relevant agreements
       (see Versioning Assistance guidelines for more details)
5.     Proof of financial participation of other investors (where applicable)                                                           (N/A   )
6.     DVD or VHS videocassette of final version of the production

7.     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)
        Corporate secretary’s certificate naming the shareholders and the number of shares held
         by each
        Corporate secretary’s certificate naming the officers and indicating their signing authority
        Declaration of Corporate Information (form available on TFC website)
        Canadian Status of Corporation Affidavit (form available on TFC website)


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.


                                                                                                                                                     TFC0210
Canada Feature Film Fund
Application for Versioning Assistance
                                                                                                                                 Page 3 of 3

                           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 Canadian Television 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 the project,
         such as the project title, 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 the 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, the CFFF guidelines and applicable Telefilm Canada business policies;
        declares that the project complies and will continue to comply with the CFFF guidelines and applicable Telefilm Canada’s
         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 solemnly 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




                                                                                                                                  TFC0210

				
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