Investiamo nel vostro futuro APPLICATION FORM Tranche Deadline IV 10 – 12 – 2014 Project title Director Category Shooting format Full-lenght feature or animation films Film Production Company (in case of co-production please fill with the leader) Name of Production Company Nationality City Address Phone / Fax Email PEC / REM Web site VAT (tax code) number In case of Co-Production Companies Name of Production Company Nationality City Address Phone / Fax Email PEC / REM Web site VAT (tax code) number Name of Production Company Nationality City Address Phone / Fax Email PEC / REM Web site VAT (tax code) number Name of Production Company Nationality Fondazione Apulia Film Commission Sede Legale: Cineporti di Puglia/Bari, c/o Fiera del Levante, Lungomare Starita 1, 70132 Bari, Italy Phone +39 080 9752900 - Fax +39 080 9147464 - P. I. 06631230726 [email protected] - www.apuliafilmcommission.it Sede Operativa: Cineporti di Puglia/Lecce, c/o Manifatture Knos, Via Vecchia Frigole 36, 73100 Lecce, Italy Sede Operativa: Cineporti di Puglia/Foggia Via San Severo, km. 2 Foggia, Italy Investiamo nel vostro futuro City Address Phone / Fax Email PEC / REM Web site VAT (tax code) number Distribution Companies Theatrical Name of Distribution Company Nationality City Address Phone / Fax Email PEC / REM Web site Broadcast Name of Distribution Company Nationality City Address Phone / Fax Email PEC / REM Web site VOD Name of Distribution Company Nationality City Address Phone / Fax Email PEC / REM Web site Contact information Name and surname Position Phone / Fax Mobile Email Fondazione Apulia Film Commission Sede Legale: Cineporti di Puglia/Bari, c/o Fiera del Levante, Lungomare Starita 1, 70132 Bari, Italy Phone +39 080 9752900 - Fax +39 080 9147464 - P. I. 06631230726 [email protected] - www.apuliafilmcommission.it Sede Operativa: Cineporti di Puglia/Lecce, c/o Manifatture Knos, Via Vecchia Frigole 36, 73100 Lecce, Italy Sede Operativa: Cineporti di Puglia/Foggia Via San Severo, km. 2 Foggia, Italy Investiamo nel vostro futuro Budget Above the line Total Film Budget Above the line Below the line Film Budget spent in Puglia Total Below the line Total € 0,00 € 0,00 Accomodation Hospitality film budget spent IN PUGLIA Board Total € 0,00 AFC Grant (70% of hospitality budget expenses in Puglia) Minimum overall project funding guarantee Media EU (specify category) Detail Category Total € € 0,00 National Public Fund € 0,00 Other Film Commission € 0,00 National distribution (Guaranteed minimum) International distribution (Guaranteed minimum) Internal Tax credit Theatrical Broadcast VOD Theatrical Broadcast VOD € 0,00 € 0,00 External Tax credit € 0,00 Co-production Companies € 0,00 Production Company participation Product placement Other Total € 0,00 Fondazione Apulia Film Commission Sede Legale: Cineporti di Puglia/Bari, c/o Fiera del Levante, Lungomare Starita 1, 70132 Bari, Italy Phone +39 080 9752900 - Fax +39 080 9147464 - P. I. 06631230726 [email protected] - www.apuliafilmcommission.it Sede Operativa: Cineporti di Puglia/Lecce, c/o Manifatture Knos, Via Vecchia Frigole 36, 73100 Lecce, Italy Sede Operativa: Cineporti di Puglia/Foggia Via San Severo, km. 2 Foggia, Italy Investiamo nel vostro futuro Pre-production – Shooting schedule – Cast and crew Pre-production in Puglia Shooting schedule in Puglia Shooting schedule outside Puglia Total shooting schedule Other location outside Puglia From To Total From To Total 0 (specify) Cast Crew Total Total Apulian personnel 0 0 Apulian Locations Listo f locations, outlining the reasons for their choice and importance of their specific features as well as the visibility of the Apulian locations chosen and their potential impact on out-of-season tourism and local economy. Privacy The undersigned, under Legislative Decree n.196 (30 June 2003), allows for the use of personal data and their transmission to third parties in fulfilment of legal obligations. Signature of legal representative Fondazione Apulia Film Commission Sede Legale: Cineporti di Puglia/Bari, c/o Fiera del Levante, Lungomare Starita 1, 70132 Bari, Italy Phone +39 080 9752900 - Fax +39 080 9147464 - P. I. 06631230726 [email protected] - www.apuliafilmcommission.it Sede Operativa: Cineporti di Puglia/Lecce, c/o Manifatture Knos, Via Vecchia Frigole 36, 73100 Lecce, Italy Sede Operativa: Cineporti di Puglia/Foggia Via San Severo, km. 2 Foggia, Italy