RETURN Reprographic Royalties Claim Form 2017

Please read the form carefully and consult the FAQ before completing it.

Only Irish publications which have an ISBN or an ISSN number can be claimed for. You can claim for any artwork or photograph that has appeared in an Irish book or magazine published anytime up until the end of 2016, so long as you own the copyright. It doesn't matter how long ago the book was published or if it has gone out of print.

The deadline for claiming is midnight, Friday 10th November 2017. 

Visual Artists Name



Are you:

If you are the artist's beneficiary, please state your name:




Your Contact Details







Publications Claims
You can claim for the reproduction of your artistic works in books, magazines or journals published in Ireland in any year up to and including the year 2016. 

Note: If one work was reproduced in a book five times, this counts as five times. If more than one work was reproduced, count each time each work was used.
Books


Provide details of each book in your claim: (If you are claiming for more than 10 books you are only required to provide details of any 10 books)






























Magazines & Journals


Note: If one work was reproduced in a magazine five times, this counts as five times. If more than one work was reproduced, count each time each work was used. Newspapers & weekend supplements cannot be claimed for.
Provide details of each book in your claim: (If you are claiming for more than 10 magazines & journals you are only required to provide details of any 10 magazines or journals)






























DECLARATION
VISUAL CREATOR


ARTISTS BENEFICIARY / HEIR





Payment Details
Payments will be made by Electronic Funds Transfer directly to your account. You may email your bank account details to info@ivaro.ie or call us at 01 6729488 to provide them. The following details must be provided by the 24th of November.

Account Payee Name, IBAN, BIC, Bank Name, Bank Address.
If you have completed the form please press Submit

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