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Dated as of ____________, 2010

The following will confirm writer/producer publisher splits with respect to the
musical composition entitled
“______________________________” (the “Composition”) to be performed and/or
recorded by
_______________________________ (the “Artist”):

Writer Names (Publisher Name/BMI, ASCAP, or SESAC, etc)

PERCENTAGE/
“RESPECTIVE SHARE”
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%

Producer Names (Publisher Name/BMI, ASCAP, or SESAC, etc)

PERCENTAGE/
“RESPECTIVE SHARE”
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%
Print: ___________________________ (____________________________/_____) _____%

AGREED TO AND ACCEPTED BY:

1._____________________________________ 7._____________________________________
Signature Signature

2._____________________________________ 8._____________________________________
Signature Signature

3. _____________________________________
9._____________________________________
Signature Signature

4._____________________________________
10._____________________________________
Signature Signature
5._____________________________________
11._____________________________________
Signature Signature

6._____________________________________
12._____________________________________
Signature Signature

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