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Reuse Report Form
Please report the following information within 48 hours of transfer. Information below will be used for billing purposes and to generate a Reuse Report Receipt as proof of reporting. Please use a separate report for each spot. Thank you!
(For your convenience, if you are a returning client, Billing Address information may be left blank.)

Name *
E-mail Address *
Company to be billed
Billing Address
City
State
Zip Code
Date of transfer *
Client/Candidate Name *
Spot Title *
Spot Number
Media Used: Radio
Media Used: Television
Media Used: Internet
Media Used: Non-Broadcast
Indicate STATE where spot will be broadcast (License includes single-client, single statewide use. Please list multi-state regional/national use under "Comments") *
Music Number & Title - Cut #1 *
Music Number & Title - Cut #2
Comments

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