Photographic authorization request

Transcription

1 Dipartimento Attività Culturali e Turismo U.O. Autorizzazioni di Pubblico Spettacolo e Cinetelevisive Servizio Autorizzazioni Riprese Cinematografiche Photographic authorization request I, the undersigned (person involved or legal representative of the juridical person).. born in.. date..... domiciled in. tel.... fax... Taxpayer s code number. Tax ardress As a legal representative of the company 1 Registered office Tel Fax... VAT Number. Person in charge on location...cell phone...; ASKS FOR Permission to take pictures of the following individuals/locations: Centrality of the assett exceeds the advertisement : in the foreground background - If advertising specify : local national international period max. Circulation: posters N Copies posters on public transport Newpapers or magazines: N.. catalog e sito web: N photo - For editorial use/ on : Books magazines weekly Periodicals catalogues/calendars/postcards circulation in one language several languages (world rights ) Number of photos to be published... title... author. 1 In the case where business is done with persons other than the legal representative, it is mandatory to present a specific act of proxy by the Company certifying the legal ownership to do business with the Office and the acts of the proceedings will be registered. 2 Cross the box related to the proceedings involved.

2 Editor cover price in Euros... edition Period from. to..;. Description of the set and Equipment Trucks occupying sq.m. SETS occupying sq.m... Attachment A is used YES NO Roma Capitale Piazza Campitelli, Roma Tel fax sandra.medaglia@comune.roma.it

3 UNDERTAKES: to pay in advance the fees given in the official price list and any eventual caution money; to put in the edition any eventual notes specified by the office; not to cede or transfer the non exclusive permission; to use the shot for only one copy of the edition; to deliver a copy of the photo to the office before distribution to the public; to abide by the laws and current regulations regarded to the territory of Roma Capitale as well as the laws mentioned in the Concession Act; to pay: - EUROS 60,00 for proceedings dues 1 fixed dues (when the request is presented) - EUROS in stamp tax stamp (when request is submitted); - the Public property occupation fee (when authorization is released); - the Sovrintendenza fee, if requested, (when authorization is released); - the caution deposit, if requested; - the envisaged payments will also have to be made, should ZTL permission be requested. N.B. Otherwise payments have to be made: - by 2 non-negotiable Italian cheques, one( 16,00 for the stamp tax) to the Treasurer's Office of the Department of Culture in Piazza Campitelli, 7, and one ( 60,00 for setting up the administration issued by an Italian Bank.) to Tesoreria Capitolina. - or by Bank transfer: IBAN:IT69P BIC UNCRITMM. ( 76,00), is asked to indicate the reason "payment of the stamp duty for photo: from....to... name of the production / person I AM AWARE THAT: - the Municipal office, will be authorized to perform controlling activities required to verify the conditions provided for releasing permission; - exemptions may be granted for taking photographs or events involving the following locations: Public Administrations, State Administrations including Institutes and Schools of all types or grades and Educational Institutes, Regions, Provinces, Municipalities, Mountain Communities, their Consortiums and Associations, University Institutions, all non economic Public Bodies, national, regional and local; - the request must be submitted even if photographic activities will not be performed in areas protected by the current regulations, but the only fee to be paid is the one regarding public property occupation; - exemptions from payment may be granted for reproductions made for strictly personal use, educational (including scientific/research) or institutional purposes and as such authorized by the pertinent bodies; - the request for authorization has to be sent even if the photographic service does not involve limited areas according to the current regulations, in which case payment will only regard the fee due for occupation of public property, if requested. I (the undersigned ) am aware of the consequences for those who release false declarations, according to art. 75 and 76 of the D.P.R. 445/2000. It is ensured that according to Dgls 196/03 the data will only be used by the Administration for the sole purpose of the proceedings involved. Date. Signature..

4 Photographic authorization request Attachment A TRUCK PLACIN: location COMPANY Period from. to..; About the following subjects : or sites (scenery / details ) Playing a single shot to the public in black / white or color n.. sq.m. required for OSP. For SET. sq.m. for no.. trucks. GRAPHIC REPRESENTATION OF SET DATE.. Signature.

5 COMPANY.... Title.. The vehicles will be used from to (1) Generating set Camera Car Truck Van Camper Cine set-up vehicle - Automobile Crane no. NUMBER PLATE TYPE (1) Length Width Height OVERALL DIMENSIONS etc. (2) When jib cranes are used, heights include the jib length. The applicant (Person or Company or their legal representative), declares under his/her own responsibility), that the above vehicles comply with the current regulations for transport inside of Roma Capitale. DATE SIGNATURE

6 ZTL Dipartimento Cultura U.O. Autorizzazioni di Pubblico Spettacolo e Cinetelevisive Servizio Autorizzazioni Riprese Person involved Juridical person Surname and Name or Company (If juridical person Surname and Name of legal representative..) born in. date.. Resident in Municipality District.. ZIP tel..... fax.... VAT entry. F.C Having received authorization for shooting in the ZTL area. Request permission to enter the ZTL on the day/days.. for the vehicles mentioned below: (complied with the current regulations for transport within the bounds of the limited Roman areas..) NUMBER PLATE TYPE (1) NUMBER PLATE TYPE (1) (1) FUEL B=gasoline E=elettric M= Methane P=Lpg I= hybrid G=diesel

7 The applicant (the person or Company involved or its legal representative) declares hereunder his/her responsibility that the above mentioned vehicles comply with the current regulations for transport within the bounds of the limited Roman areas (ZTL). DATE SIGNATURE The sum to be paid is for no.. Vehicles and has been paid on the on C/C no in the name of the Roma Capitale Dip.Mobilità - Ufficio Permessi Centro Storico Piazza Campitelli, Roma Tel fax sandra.medaglia@comune.roma.it