STAGE 1: EXPRESSION OF INTEREST
Office use only
INDIGENOUS DEPARTMENT
App. No. ........................ … Rec ……………………..
INDIGENOUS
FEATURE
DOCUMENTARY
INITIATIVE
PEP Eligible:…………………
Please make sure you:
 read Screen Australia’s guidelines for the Indigenous
Documentary Feature Initiative; see
www.screenaustralia.gov.au/indigenousfeaturedoco
 complete all questions on this application form
 compile the supporting documentation specified on page 12.
If you have any questions, please contact our
Program Operations team on 1800 507 901 or via
indigenous@screenaustralia.gov.au
This form must be completed using Microsoft Word. You can use the tab key to jump to the next field.
APPLICANT COMPANY
ABN
KEY PRINCIPAL CONTACT FOR THIS APPLICATION
One of the Key Principals listed in Section 3 of this form must be nominated as the person responsible for this application,
all official correspondence will be sent to this person.
NAME
Role on the project: [select]
Mobile
State of
Email
residence
[select]
ADDITIONAL CONTACT PERSON IF RELEVANT
All official correspondence will be sent to the Key Principal Contact listed above. However, if you wish to nominate an additional
contact person, who will be cc’ed on email correspondence and listed as a backup for phone communications, please provide
details here.
Name
Phone
Email
PROJECT TITLE
AKA (list any former titles)
Screen Australia
Amount requested
$
(up to $500,000)
Total budget
(do not use a range)
$
APPLICATION IS FOR
Production OR
Post-production
I am also applying for Producer Equity
Please note:
In the case of projects which may be eligible for the Producer Offset, rather than Producer Equity, you do not need to apply for
Provisional Offset Certification unless your project is approved for a Letter of Offer. Provisional Certification must then be confirmed
before funds can be released.
PREVIOUS SUBMISSIONS
Please indicate whether this project has been submitted previously (irrespective of whether the application was successful) to:
the AFC
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Film Australia
the FFC
Screen Australia
Not previously submitted
SCREEN AUSTRALIA EOI APPLICATION: INDIGENOUS FEATURE DOCUMENTARY INITIATIVE – MAY 2015
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PROJECT INFORMATION
Project type:
One-off documentary of
mins
Marketplace attachment/s if applicable
Name of company/ies
Has the project ever been considered by a distributor or domestic broadcaster?
No
Yes, If yes, provide details.
Do you intend to access international finance for this project?
No
Yes, If yes, provide details.
ELIGIBILITY STATEMENT
The project that is the subject of the application:
is an innovative observational or social justice feature-length documentary intended for public release, AND
is not primarily a game, an extension to a film or TV program, or content made for primarily for educational or
training purposes, AND
does not exceed the cap which limits funded projects to a maximum of 15 commercial hours, including multiple
series.
AND EITHER (tick one)
has not previously been assessed and declined for Screen Australia funding, OR
has previously been assessed and declined for Screen Australia funding once only, AND significant changes have
been made since the previous submission, AND a statement setting out the changes is attached.
The creative team responsible for the project:
includes an Indigenous writer
includes an Indigenous director
includes one key principal who has at least two ‘eligible credits’ in their respective role (this may be the producer
or director, or equivalent role relevant to the type of project).
For linear documentaries, and linear projects with multiplatform elements, an ‘eligible credit’ is a linear
documentary which is not more than 10 years old, is half hour or longer in duration, and has:
– been broadcast by a recognised broadcaster or channel; or
– had a commercial theatrical release; or
– been invited to screen at IDFA, Hot Docs or equivalent.
For interactive documentaries, an ‘eligible credit’ must be an equivalent project which has been publicly released.
Note that corporate, education, training or community access programs are not acceptable credits for eligibility
purposes.
You will need to provide information about relevant credits in the next section.
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CREATIVE TEAM
KEY PRINCIPALS
Please provide the information requested below for each Key Principal, including the Key Principal Contact from page
1. These are the key members of the creative team who are confirmed and integral to the funding requested – the
producer, executive producer, director and/or writer, as relevant. This information will also be used to confirm
eligibility.
NAME
Role
Gender:
[select]
Australian citizen/resident:
Mobile:
[select]
[select]
State of residence
[select]
Email:
Relevant credits:
Project title
Credited role
Type (eg one-off
doc, series)
Duration
(if relevant)
Budget ($)
Production
year
Release details (broadcast,
screening or festival info)
200-word bio
NAME
Role
Gender:
[select]
Australian citizen/resident:
Mobile:
[select]
[select]
State of residence
[select]
Email:
Relevant credits:
Project title
Credited role
Type (eg one-off
doc, series)
Duration
(if relevant)
Budget ($)
Production
year
Release details (broadcast,
screening or festival info)
200-word bio
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NAME
Role
Gender:
[select]
Australian citizen/resident:
Mobile:
[select]
[select]
State of residence
[select]
Email:
Relevant credits:
Project title
Credited role
Type (eg one-off
doc, series)
Duration
(if relevant)
Budget ($)
Production
year
Release details (broadcast,
screening or festival info)
200-word bio
NAME
Role
Gender:
[select]
Australian citizen/resident:
Mobile:
[select]
[select]
State of residence
[select]
Email:
Relevant credits:
Project title
Credited role
Type (eg one-off
doc, series)
Duration
(if relevant)
Budget ($)
Production
year
Release details (broadcast,
screening or festival info)
200-word bio
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NAME
Role
Gender:
[select]
Australian citizen/resident:
Mobile:
[select]
[select]
State of residence
[select]
Email:
Relevant credits:
Project title
Credited role
Type (eg one-off
doc, series)
Duration
(if relevant)
Budget ($)
Production
year
Release details (broadcast,
screening or festival info)
200-word bio
Please indicate if the project has an Indigenous
producer
director
writer
no Indigenous principals
OTHER TEAM MEMBERS AS APPLICABLE
Role
Name
Confirmed?
Australian
resident/ citizen?
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
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PROJECT CREATIVE DETAILS
SYNOPSIS (refer to Screen Australia handout What is a Synopsis? An Outline? A Treatment?)
One-line synopsis (logline – max 50 words)
One-paragraph synopsis (max 120 words)
PATH TO AUDIENCE OVERVIEW
Briefly summarise (max 120 words) the key features of how you propose to finance and release the project
As part of this application, you must also provide a separate written proposal (3–5 pages ONLY) incorporating
 an outline or treatment of the proposed project making clear reference to structure, characters, and stylistic
and visual approach
 the key principals’ vision for the project and how they plan to get it made and seen.
VIDEO MATERIAL
You may also provide video material to support your application, including:
 a simple talk-to-camera video pitch, maximum two minutes, where key principals present their vision for the project.
AND/OR
 up to five minutes of sample footage or sizzle reel.
Format requirements: MP4 or WMV file, H.264, resolution 720p; FILES MUST BE LESS THAN 100MB
ONLINE SCREENING LINKS if available
(if not you will need to provide the material on
DVD or USB)
(This must be a download-enabled link for Screen Australia record-keeping purposes.)
Password if relevant:
(This must be a download-enabled link for Screen Australia record-keeping purposes.)
Password if relevant:
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SCHEDULE
PROPOSED PRODUCTION SCHEDULE
Please provide proposed dates for key milestones.
Date
/ /
Start of pre-production
Start of production (principal photography)
/
/
Start of post-production
/
/
Delivery
/
/
PREVIOUS FUNDING
Please indicate any previous development or other funding provided to this project:
1. By Screen Australia or its predecessor agencies (for Enterprise Program companies, this should include any
development funds allocated to this project from Enterprise funds)
Agency/ Funder
Year
Description
Amount
$
$
$
$
TOTAL (this should be included in your finance plan and will form part of Screen Australia’s total investment in the project)
$
2. By other entities, including State and Federal government agencies, broadcasters or other third-party investors.
Agency/ Funder
Year
Description
Amount
$
$
$
$
TOTAL
$
BUDGET AND FINANCING
If your project is shortlisted, you will be invited to provide (within four weeks of receiving the invitation):

A detailed budget and budget summary using the relevant standard Screen Australia A-Z budget format available from
www.screenaustralia.gov.au/a-zbudget.
See www.screenaustralia.gov.au/funding/business/Applicant_info.aspx for budget requirements.

A finance plan spreadsheet using the template available from
www.screenaustralia.gov.au/funding/documentary/ProducerProgram.aspx
Note: We expect that the total project budget and the amount you are requesting from Screen Australia will not
differ significantly from the amounts proposed in Stage 1 – Expression of Interest.
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RIGHTS
In order to receive Screen Australia funding, the Applicant must either hold the rights or have an appropriate option to
acquire the rights necessary to produce the project. This includes, for example, the copyright in a script or treatment, and the
right to make the project if it is based on another work such as a book, format, unpublished manuscript, etc).
Please provide a brief narrative overview of the ‘chain of title’ for this project (for example: ‘This project is based
on a novel by [author]. [Screenwriter] was retained by [production company] to write a script based on the book.’
Please provide details of all works on which the project is based and the status of the chain of title
documentation for each:
Type of
Work
Title of
Work
Author/
creator
Rights Holder
(see below )
Documentation/ Status
(see below )
Option Expiry
Date (where
relevant)
Eg.
Book
[select]
“The Big
Bang”
Jane Author
My Company/ Her
Publisher
Option Agreement between My Company and
Her Publisher dated 1 November 2011.
1 November 2013
[select]
[select]
[select]
[select]
[select]
[select]
[select]
[select]
 For each work:

Where the Rights Holder is the Applicant, please list under ‘Documentation/Status’ the documents that establish this
(the ‘chain of title documentation’), eg development agreement, option agreement, assignment agreement etc,
including the parties to the agreement and its date

Where the Rights Holder is not the Applicant, please list under ‘Documentation/Status’ any documents currently in
place (eg letter of intent, or in-principle agreement) or describe how the Applicant intends to obtain the necessary
rights.
If your application is approved, you will need to provide an opinion letter from an appropriate solicitor confirming you have
the rights to make the film before funds can be released. You may also need to provide all or some of the chain of title
documents listed above on request.
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CLEARANCES
Is the project partly or wholly based on a real life event or person? [select]
If yes, please provide details, including whether releases, in-principle agreements or access agreements have been
obtained.
Is the project dependent on obtaining releases or access agreements from individuals or bodies such as local
councils, government or private organisations? [select]
If yes, please detail the type of release/s or agreement/s required and whether you have a signed copy.
ABORIGINAL AND/OR TORRES STRAIT ISLANDER CONTENT OR PARTICIPATION
Does the project involve Indigenous content or the participation of Indigenous people?
For example, does the project focus on Indigenous issues, or an Indigenous person or community? Or use Indigenous
communities or land as locations? Or draw on or refer to Indigenous culture and heritage in any form? Even if you think
the Indigenous elements are incidental, please outline them here.
No
Yes – if Yes, please describe the nature of the involvement – the role Indigenous content or
participation plays in the project
PLEASE NOTE: Particular requirements for consultation and consent apply where Indigenous content or participation is
involved. If your application is shortlisted, you will need to provide:
- a consultation plan setting out how you are approaching the Indigenous content or participation with regard to appropriate
protocols;
- signed evidence of consultation undertaken to date, and
- signed letters of consent if the project involves particular individuals or communities.
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CONTRACTING INFORMATION
Please provide the requested information for the company with whom Screen Australia will contract if this
application is successful.
Existing company (provide details below)
Not yet established
Company name
ABN
Please use full company name, including Pty Ltd and ‘trading name’ if relevant, eg ‘Lettuce Films Pty Ltd trading as Lettuce Salad’
Address: Street
City
State
Phone
Email
Postcode
Is this company an SPV?
Yes
No
If yes, please provide details of parent companies below:
Parent company name
ABN
Please use full company name, including Pty Ltd and ‘trading name’ if relevant, eg ‘Lettuce Films Pty Ltd trading as Lettuce Salad’
Address: Street
City
State
Phone
Email
Parent company name
Postcode
ABN
Please use full company name, including Pty Ltd and ‘trading name’ if relevant, eg ‘Lettuce Films Pty Ltd trading as Lettuce Salad’
Telephone
Email
Address: Street
106763970
City
State
Phone
Email
SCREEN AUSTRALIA EOI APPLICATION: INDIGENOUS FEATURE DOCUMENTARY INITIATIVE – MAY 2015
Postcode
10
GENERAL ELIGIBILITY
Do the Individual Applicants, Applicant Company, or related parties have any outstanding debts (eg debts under P & A
loan agreements or gross proceeds not paid as required) to Screen Australia or its predecessors?
No
Yes, to
Screen Australia
AFC
FFC
Film Australia
If YES, please provide details:
Do the Individual Applicants, Applicant Company, or related parties have any other outstanding contractual obligations
to Screen Australia or its predecessors on another project (eg overdue delivery items, audits, cost reports, recoupment
reports)?
No
Yes, to
Screen Australia
AFC
FFC
Film Australia
If YES, please provide details:
Please tick to confirm:
The Applicant:
is an Australian citizen or resident,
is not a full-time tertiary film student,
is not an employee of a broadcaster, related body corporate, or company jointly owned by one or more broadcasters.
will always act ‘in good faith’ in all their dealings with Screen Australia
has the capacity and resources to carry out the project that is the subject of the application
has the right to carry out the project that is the subject of the application (including any relevant copyright & clearances)
has meaningful creative control of the project that is the subject of the application.
Where the Applicant is a Company:
the Company is incorporated in Australia, carries on business in Australia, and has its central management and control
in Australia
the Company is not a broadcaster, a related body corporate of a broadcaster, or a company jointly owned by one or
more broadcasters.
DECLARATION
Applicants must provide accurate information to Screen Australia at all times. A person or company that makes a false or
misleading statement to Screen Australia in an application may face criminal or civil liability including liability for an offence
under the Criminal Code Act 1995.
In submitting this application, I declare that:
(a) the information provided herein and in the supporting documentation submitted with this application is complete and
accurate; and
(b) I have read and agreed to the Screen Australia Terms of Trade and the relevant funding guidelines; and
(c) I acknowledge that this application form contains personal information and that Screen Australia will manage this
information in accordance with the Screen Australia Privacy Policy and the Privacy Act 1988. I have read and
understand Screen Australia’s Privacy Policy. I have obtained the consent of all individuals named in this form to provide
Screen Australia with the personal information about them in the form, and confirm that I have made them aware that this
information will be managed in accordance with Screen Australia’s Privacy Policy and the Privacy Act 1988.
DATE:
–
DAY
106763970
–
MON
YEAR
SCREEN AUSTRALIA EOI APPLICATION: INDIGENOUS FEATURE DOCUMENTARY INITIATIVE – MAY 2015
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SUBMITTING YOUR APPLICATION
Email the following to: indigenous@screenaustralia.gov.au
by 5.30pm AEST/AEDT on the deadline date specified on the Screen Australia website.
Documents should be named as indicated in the checklist below, and attached to the email as a zipped folder
(please do not put documents into subfolders).
this completed application form (as a Word document).
[filename: application form – project name.doc or .docx]
your 2-page ONLY producer’s statement including broad plans for production and distribution.
[filename: producer statement – project name.doc or .docx]
your 3–5 page ONLY written proposal incorporating:
 an outline or treatment of the proposed project making clear reference to structure, characters and stylistic
and visual approach, and
 the key principals’ vision for the project and how you plan to get it made and seen.
[filename: proposal – project name.doc or .docx]
CVs for each of the creative team (producer, director, writer or equivalent key roles relevant to the project),
as well as any other confirmed key personnel (DOP, editor, etc).
[filename: CV – person name – project name.doc or .docx or .pdf]
Are you submitting a pitch-to-camera (max two minutes)?
Are you submitting sample footage or a sizzle reel (max five minutes)?
No
link provided page 6
No
link provided page 6
Video format requirements: MP4 or WMV file, H.264, resolution 720p; FILES MUST BE LESS THAN 100MB
Note: we will assess your application based on the materials received as of the deadline date. We will
not accept additional materials after this date, nor will we accept documents which exceed the specified
limits.
If your application is shortlisted, you must be available to provide additional materials within four weeks
of being advised. See program guidelines for more information.
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