Image Copyright permission and License Agreement.

I am the Photographer who owns the copyright to this image or was given copyright permission by the photographer or

I am the copyright owner and own the rights to these images by copyright transfer from the photographer to myself.

Please provide the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

The person in this photograph is:

Choose one of the following options:

I want to License this image and I am sole copyright owner. I want to co-license this Image and share royalty payments.

I give permission to edit the image as needed for printing on labels.

Yes Edit Image as needed. I will send large file. No, please use as is from large file sent by me.

This is the information I want on the webpage to credit this image: (Photographer or Model Name, link to there website etc.)

The royalty is 3%. What percent of 3% do you want Model on a Bottle to pay the Photographer? 0%,1%, or 2% , 3% or exactly half which is 1.5% from all future bottled water sales that have this image?

The royalty payment is 3% total to either the Photographer, the Model, Image owner or both. Please choose a remaining percent to pay to the Model in the Image; 0%, 1%, 2%, 3% or exactly 1.5% which is half the royalty on all future sales from bottled water that has this image.

Percent of the cash bonus to be awarded to the Photographer or Image copyright owner will be what percent of 100% of  cash bonus? Enter a percent from 0%-100%.

What percent of the remaining % will go to the Model? Please enter any remaining percent of the cash bonus from 0% to 100%. Example if photographer is awarded 50% of cash bonus then the Model would have the other 50% of the total 100%.

Under penalty of perjury I declare I am of the legal age to execute agreements and hear by agree to give Model on a Bottle and it's assigns copyright permission to use this image on bottled water labels and any related advertising associated with the sales thereof and to pay myself and or featured person I have listed.

I understand that Images must be emailed to modelonabottle@yahoo.com  and must be a minimum of 5 MB to be suitable for printing. Initial below.

I am the Photographer and this agreement was discussed with the Model and the Model agrees with everything I have committed to. Initial below if true.

I am the Photographer or Model or Musician or Celebrity or Athlete or Artist and  I have complete copyright or copyright permission and can produce proof. 

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