MUZIQUEEN PUBLISHING ADMINISTRATION

SONGWRITER SPLIT SHEET

Song Title: ______________________________________________________ Date Complete:______________

Song ISRC: ___________________________________

Recording Artist: ____________________________________________________________________________

Record Label: _______________________________________________________________________________

Studio Name: ________________________________________________________________________________

Address:____________________________________________________________________________________
_______________________________________________ Phone: __________________________

Sample: YES NO (Circle one)

Album and Artist where Sample originated: _______________________________________________________

Composer/Writer 1: _________________________________________________________________________
Address:____________________________________________________________________________________
_______________________________________________ Phone:__________________________
Publishing Company (if a 3rd party is entitled to a % of Publishing, list this party’s information as well):
________________________________________________________________ Publishing %:____________
________________________________________________________________ Publishing %:____________
Affiliation: ASCAP BMI SESAC (Circle one)
Total Ownership %: _______________ Lyrics: _________ Music: __________ (Identify each % of ownership)

Writer/Composer Signature: _________________________________________________________________

CAE/IPI/SSN: _____________________________________ Birthdate: ___________________________

Composer/Writer 2: _________________________________________________________________________
Address:____________________________________________________________________________________
_______________________________________________ Phone:__________________________
Publishing Company (if a 3rd party is entitled to a % of Publishing, list this party’s information as well):
________________________________________________________________ Publishing %:____________
________________________________________________________________ Publishing %:____________
Affiliation: ASCAP BMI SESAC (Circle one)
Total Ownership %: _______________ Lyrics: _________ Music: __________ (Identify each % of ownership)

Writer/Composer Signature: _________________________________________________________________

CAE/IPI/SSN: _____________________________________ Birthdate: ___________________________
Composer/Writer 3: _________________________________________________________________________
Address:____________________________________________________________________________________
_______________________________________________ Phone:__________________________
Publishing Company (if a 3rd party is entitled to a % of Publishing, list this party’s information as well):
________________________________________________________________ Publishing %:____________
________________________________________________________________ Publishing %:____________
Affiliation: ASCAP BMI SESAC (Circle one)
Total Ownership %: _______________ Lyrics: _________ Music: __________ (Identify each % of ownership)

Writer/Composer Signature: _________________________________________________________________

CAE/IPI/SSN: _____________________________________ Birthdate: ___________________________

Composer/Writer 4: _________________________________________________________________________
Address:____________________________________________________________________________________
_______________________________________________ Phone:__________________________
Publishing Company (if a 3rd party is entitled to a % of Publishing, list this party’s information as well):
________________________________________________________________ Publishing %:____________
________________________________________________________________ Publishing %:____________
Affiliation: ASCAP BMI SESAC (Circle one)
Total Ownership %: _______________ Lyrics: _________ Music: __________ (Identify each % of ownership)

Writer/Composer Signature: _________________________________________________________________

CAE/IPI/SSN: _____________________________________ Birthdate: ___________________________

Composer/Writer 5: _________________________________________________________________________
Address:____________________________________________________________________________________
_______________________________________________ Phone:__________________________
Publishing Company (if a 3rd party is entitled to a % of Publishing, list this party’s information as well):
________________________________________________________________ Publishing %:____________
________________________________________________________________ Publishing %:____________
Affiliation: ASCAP BMI SESAC (Circle one)
Total Ownership %: _______________ Lyrics: _________ Music: __________ (Identify each % of ownership)

Writer/Composer Signature: _________________________________________________________________

CAE/IPI/SSN: _____________________________________ Birthdate: ___________________________