Fill and Sign the Permission Picture Form

PERMISSION TO UTILIZE PROPERTY FOR A MOTION PICTURE OR PHOTOGRAPHY SHOOT Permission is hereby granted to (hereinafter referred to as “FILMMAKER”) to use the property located at in the state of for the purpose of photographing and/or recording scenes (still and moving) for motion pictures, with the right to exhibit and license others to exhibit a ll or any part of said scenes in motion pictures or still photography throughout the world. Said permission to film and/or photograph is scheduled and shall begin on or around the day of , 20 and may be rescheduled due to inclement weather, schedule, or filming delays. Permission shall include the right to bring personnel and equipment, including props, actors, sets, etc., onto the aforementioned premises and shall be removed on or around the day of , 20 or continuing until completion of all scenes and required work. Upon completion of shooting, said property shall be returned to its previous condition free from any waste or nuisance to the property owner. The following $ fee is to be paid for the use of the aforementioned premises assessed daily weekly monthly one time fee. FILMMAKER agrees to hold the undersigned property owner harmless of and from any and all liability and loss that FIMMAKER or property owner may incur as a result of FILMMAKER’S presence (including employees, props etc.) on said property. The undersigned does hereby represent to have full authority to grant FILMMAKER license to use and occupy said property and to enter into this Agreement. Name of Property Owner Date _____________________ Signature Project or Picture Title FILMMAKER or agent Date _____________________ Signature