Films and Publications Act, 1996 (Act No. 65 of 1996)RegulationsFilms and Publications Regulations, 2014AnnexuresAnnexure I : Board/EX |
Annexure I
BOARD/EX
FILM AND PUBLICATION BOARD
420 WITCH HAZEL, ECO GLADE 2, ECO PARK
CENTURION 0169
PRIVATE BAG X 31, HIGHVELD 0169
E-MAIL: [email protected]
Website: www.fpb.org.za
Application exemption in terms of section 22 or 23 [regulation 24] |
The Film and Publication Board may refuse to process your application if this form is not fully completed |
Ref. No. (Office Use) |
DATE OF APPLICATION |
DATE RECEIVED (Office use) |
APPLICANT |
POSTAL ADDRESS |
|||
POSTAL CODE |
CONTACT PERSON |
TEL |
FAX |
TITLE (for distribution/exhibition) |
PREVIOUS TITLE (if different) |
ORIGINAL |
RE-RELEASE |
FORMAT |
35MM |
VIDEO |
DVD |
VCD |
CD- ROM |
OTHER |
RUNNING-TIME IN MINUTES, AS SUBMITTED |
SUBJECT OR GENRE |
DIRECTOR |
CAST INCLUDES |
|
LANGUAGE |
ORIGINAL |
DUBBED |
SUB-TITLED |
PREVIOUS CLASSIFICATION AND CONSUMER ADVICE |
CERTIFICATE NUMBER |
FORMAT |
SIGNED |
DATE |
CAPACITY |
NOTE:
| 1 | Proof of your right to distribute and/or exhibit this film in South Africa, in the format submitted, must be attached to this form |
| 2 | Unless exempted from the cash-on-submission basis, payment in full of the applicable amount must be made before this application may be processed. Where payment has been made by direct deposit into the account of the Board, proof of such deposit must be attached to this form. |
| 3 | You must provide, free of charge, a copy of this film, as soon as it becomes available in home-entertainment format, to the Board for its records. |