|
INFORMATION FOR ROYALTY, LEASE OR ANNUITY CONTRACT |
|
Date of Contract |
|
|
Description of Paying Entity (Individual, Corporation, Insurance Company, ASCAP, BMI, etc) |
|
|
Original Contract Value |
$ |
|
Original Term of Contract
(Specify Years, Quarters, Months) |
|
|
Payment Frequency |
Annually
Quarterly
Monthly
Other Describe
|
|
Payment Amount |
$ |
|
Please describe Changes to Payment Over Time (Contingencies, Escalators, etc) |
|
|
First Payment Date |
|
|
Last Payment Date |
|
|
Next Scheduled Payment Date |
|
|
Number Payments Remaining |
|
|
Please Describe any other Contract Terms you think would
be useful in determining the Contract Value |
|
|
Quote Desired If Partial, Indicate Amount of Cash
Desired Now |
Total Buyout of Remaining Contract
Partial Buyout  $ Partial Amount
|
|
|