Authorization request shops, businesses, miscellaneous

Authorization Application for Commercial Areas

General informations

Last name and first name of the manager * :

Quality of the manager (owner, manager, etc.)* :

E-mail* :

Company name of the establishment* :

City * :

Zip Code* :

No.* :

Adress* :

Phone* :

Trade register number :

VAT no. :

Denomination:

The head office:

Date of start of hearings *:

Nature of your business *

General sound system:

Sound area *

Are you a member of a professional body (confederation, federation) ?

Yes. Which one?

Devices or media used

Radio without additional speaker

Radio with additional speaker

CD / DVD / MP3 / MP4 / USB key / Streaming

Validation

Last name and first name * :

This request for authorization is established under the full responsibility of the signatory which certifies him/her to have agreed to the general terms and conditions and the privacy policy

I, the undersigned, certify the information indicated above as sincere and hereby request the SACEM's prior authorization provided for in article 4 of Luxembourg copyright law and in accordance with the terms of the International Convention Berne revised in Brussels on June 26, 1948.

Please note that the invoice for your request will be sent to you by email.