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Film Footage Invoice (You must also complete the Letter of Agreement)

Office Use Only:		Patron: Please Provide Instructions for Dubbing (FORMAT of DUB, time-code, user-bit numbers, etc.)
Action:	DATE:	-
Dub sent to client	-	-
Dub payment rec'd	-	-
Use fee payment rec'd	-	-
Dub returned to HFM	-	-
		(Please attach an additional page if necessary)

Refer to the "Film Footage Fee Schedule" to determine costs. (Please attach an additional page if necessary.)

	Office Use Only: VT/AFC#	Accession #	Title/Caption/Description	Location of Original (if applicable)	Costs
1	-	-	-	-	Dubbing Use Fee	_________
2	-	-	-	-	Dubbing Use Fee	_________
3	-	-	-	-	Dubbing Use Fee	_________
4	-	-	-	-	Dubbing Use Fee	_________
5	-	-	-	-	Dubbing Use Fee	_________

	Subtotal:	_________
	Tax Exempt #:___________________ or 8.375% Tax (NY residents):	_________
	Total	_________

Method of Payment (Payment must be made in U.S. dollars drawn on a U.S. bank):
____ Cash (for in-person orders only)
____ Check or Money Order made payable to "MVSHQ, Inc."
____ Qchex or PayPal to billing@rms-republic.com
                                                
____ Credit Card : Name on Card_____________________________________
                   Credit Card#_____________________________________                                             
                   Expiration Date__________________________________                          

We Accept: Mastercard; Visa; Discover; and American Express.