Mini-Treaty Canada-France:
For Telefilm
Canada use only:
Application #
Date received (Y/M/D):
Original French-language Television Program
Selective Financial Assistance in Development
Application form
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Applicants should be familiar with the Mini-Treaty Television Development – Agreement between the Government of Canada and the
Government of the Republic of France Regarding the Development of French Language Audiovisual Co-Production Projects for Television (the
“Mini-Treaty Television Development Agreement”), the Financial Selective Assistance for Canada-France Coproductions Information Document
(the “Mini-Treaty Information Document”) and the applicable Telefilm Canada business policies prior to completing this application form.
Please complete all information requested and include all relevant documentation with your application. Please note that this application form
must be signed by all applicants prior to submission to Telefilm Canada.
Title:
Previous Title(s):
ISAN Number (if applicable; 26 digits):
A. APPLICANT INFORMATION
Name of Canadian Production Company(ies) (Applicant):
Name of Foreign Production Company 1:
Address
City
Country Canada
Tel
Email address
Address
City
Country
Tel
Province
Postal code
Fax
(for official notifications)
Web address
Contact Name for this file (Name & Title):
Province
Postal code
Fax
France
Email address
Web address
Name of Parent Company (if applicable):
Name of Foreign Production Company 2:
Address
City
Country Canada
Tel
Email address
Address
City
Country
Tel
(for official notifications)
Web address
Province
Postal code
Fax
Province
Postal code
Fax
France
Email address
Web address
Are you sure that your Co-Producer(s) submitted an application to the competent authority?
Yes
No
B. PROJECT HISTORY
Has this project ever been submitted to Telefilm Canada or the CMF/CTF?
If it received funding, please provide the following information:
Application Number
At what stage?
Amount
Date of contract
Yes
No
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Mini-Treaty Canada-France / French-language television / Development – Application Form
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C. PROJECT INFORMATION
Synopsis (100 words or less):
Number of episodes
episodes
Duration
Production type
Live action
Language
Category
Drama
Children’s
Documentary
Format
Pilot
One-off
Mini-Series
minutes / episode
French
Series
MOW
If the screenplay is based on an original work:
Title of original work
Medium (book, play, etc.)
Author
Citizenship of Author
D. CULTURAL CONTENT INFORMATION (check only one)
Cultural content refers to content only; NOT to production personnel. This information is gathered for statistical purposes only.
Aboriginal
Multicultural
General
(PRIMARILY about aboriginal
characters or issues)
(PRIMARILY about visible minority characters or issues OR
characters or issues based on first generation immigrants to
Canada from Eastern Europe or Latin America)
(all other projects)
E. SCHEDULE INFORMATION
Projected completion date for this development request
Estimated shooting start date
Y
M
D
F. PARTICIPANT INFORMATION
Project Participants
Canadian Producer
Last Name
First Name
Citizenship
Confirmed
Foreign Producer 1
Foreign Producer 2
Executive Producer
Scriptwriter(s)
Story Editor / Consultant
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Mini-Treaty Canada-France / French-language television / Development – Application Form
Project Participants
Researcher
Last Name
First Name
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Citizenship
Confirmed
Director
Are there any third country participants involved in the project?
Function
Last Name
First Name
Yes (complete table below)
Citizenship
No
Reason
G. FINANCIAL INFORMATION
Category of Financing
Legal Name of Company or
Organization
Type of Financing
Amount
%
of Total
Confirmed
Telefilm Canada – Mini-Treaty
Advance
$
%
-
Canada Media Fund – TV Development
Advance
$
%
-
Production Company
$
%
Broadcast Company
$
%
Other
$
%
Other
$
%
Total Canadian Financing
$
%
CNC – Mini-Treaty
Advance
$
CNC – Others
Advance
$
Foreign Prod. Co. 1
$
Foreign Prod. Co. 2
$
Broadcast Company
$
Other
$
Other
$
Total Foreign Financing
$
%
TOTAL FINANCING
$
100.0 %
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Mini-Treaty Canada-France / French-language television / Development – Application Form
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H. BUDGET INFORMATION
Date of budget (Y-M-D)
EXPENDITURES
per Producer
per country
In Canada
Country of expenditure
In Foreign
Country 1
In Foreign
Country 2
Other Countries*
Total
(per Producer)
Canadian Producer(s)
$
$
$
$
$
Foreign Coproducer 1
$
$
$
$
$
Foreign Coproducer 2
$
$
$
$
$
$
$
$
$
$
Total (per country)
*If the breakdown includes expenses under Other Countries (non-coproducing countries), complete the following table:
Nature of expense
Amount
Reason spend necessary outside
coproducing countries
Country of
expenditure
Producer
covering cost
$
$
$
$
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Mini-Treaty Canada-France / French-language television / Development – Application Form
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Required Documents at time of Application
N/A
Enclosed
Mini-Treaty Canada-France: French-Language Television Development Program
At the time of application, together with this completed application form, the applicant must provide all of the
documentation listed below. Please be advised that during the review of the project, the applicant may be required to
provide additional documentation or information. Telefilm Canada reserves the right to request any document or
information it deems relevant, including, but not limited to, any document or information pertinent to the eligibility of
the applicant and the project.
Please be advised that Telefilm Canada will not act as a depositary or be responsible in any way for the holding or
return of any material submitted at any time in connection with the application or the project and such material may be
destroyed at any time.
1.
Corporate Documentation

(only if modified since company’s last
application to Telefilm)



Incorporation documents for the applicant production
company and parent company(ies), if applicable
Corporate financial statements for the past three (3) fiscal
years1
Shareholder or partner’s agreement (as applicable)
Declaration of Canadian Status of Corporation and
Corporate Information (available on Telefilm website)
2.
Most recent creative material
e.g. script, bible
3.
Proof of citizenship of Canadian
producers, executive producers,
key creative personnel
Proof of citizenship or permanent residency for (1) all Canadian
producers and executive producers; and (2) all Canadian key
creative personnel.
Admissible proof of citizenship: legible photocopy of passport, birth
certificate, citizenship certificate, or CAVCO personnel number.
Admissible proof of permanent residency: valid permanent resident
card for the duration of the production.
4.
Notarized affidavit(s) for Canadian
producer(s) and writer(s)
Available on Telefilm website (“coproduction”)
5.
Co-development agreement
Duly executed
6.
Chain of Title
Contracts establishing full chain of title for the property, in
particular, origin of concept
7.
Development budget
Detailed budget (in CA$), dated, in multi-column format showing
each country’s participation in a separate column and a
consolidated column.
8.
Financial structure
Itemized financial structure (in CA$) for the Canadian and French
producer indicating sources of financing
9.
Broadcast agreement(s)
Canada and/or France broadcast agreement(s) or letter(s) of
commitment or letter(s) of interest
1. The applicant must provide for the last three fiscal years:
(a) Consolidated and audited annual financial statements, if consolidated annual gross revenue of the applicant and its related parties is
equal to or greater than $10 million;
(b) Consolidated annual financial statements, together with a review engagement report if consolidated annual gross revenue of applicant
and its related parties is equal to or greater than $5 million but less than $10 million;
(c) Non-consolidated annual financial statements, together with a notice to readers if consolidated annual gross revenue of the applicant
and its related parties is less than $5 million.
Notwithstanding the foregoing, Telefilm reserves the right to request from the applicant, at any time and at Telefilm’s absolute discretion,
consolidated and audited annual financial statements.
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Mini-Treaty Canada-France / French-language television / Development – Application Form
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TELEFILM CANADA IS SUBJECT TO
THE ACCESS TO INFORMATION ACT AND THE PRIVACY ACT.
PRIVACY NOTICE:
In order to process this application, Telefilm Canada requires certain personal information about, among other things, the applicant
or the applicant’s authorized representative, and about the co-applicant or the co-applicant’s authorized representative if
applicable. This information may consist of − among other things − the name, citizenship, coordinates and biographical information
of the applicant or the applicant’s authorized representative, and of the co-applicant or the co-applicant’s authorized representative
if applicable. As well, the curriculum vitae, citizenship and other personal information of members of the creative personnel involved
with the application may be included, if applicable. The collection and use of such personal information are in accordance with the
Privacy Act [1] and section 10 of the Telefilm Canada Act.[2] Said personal information is collected so as to, among other things,
enable the applicant to present this application, as well as to enable Telefilm Canada to carry out the processing of such application.
Personal information may also be used for, among other things, conducting surveys with the applicant or the applicant’s authorized
representative, and with the co-applicant or the co-applicant’s authorized representative if applicable, for program evaluation
and/or assessing client satisfaction. The personal information collected by Telefilm Canada in connection with this application, along
with its related uses, are featured in the class of personal information entitled “Applications and Projects” published in Telefilm
Canada’s Info Source profile,[3] as well as in Personal Information Banks “Automated Document, Records, and Information
Management Systems” (PSU 904), “Public Communications” (PSU 914) and “Outreach Activities” (PSU 938). [4]
By presenting this application, the applicant or the applicant’s authorized representative, and the co-applicant or the co-applicant’s
authorized representative if applicable, confirm(s) that he(they) has(have) read this Privacy Notice Statement and is(are) ready to
provide personal information in accordance with it.
[*] The masculine gender is used throughout to simplify the text.
__________________________________
[1] http://laws-lois.justice.gc.ca/eng/acts/P-21/
[2] http://lois-laws.justice.gc.ca/eng/acts/C-16/
[3] http://www.telefilm.ca/en/node/19201
[4] http://www.infosource.gc.ca/emp/emp03-eng.asp
APPLICANT(S) STATEMENTS:
The undersigned authorized representative of the applicant and co-applicant (if applicable) hereby:

authorizes Telefilm Canada to discuss and disclose any information concerning any aspect of the funding application, the
project, any previously completed project, the applicant and any related party to the applicant, with every entity connected
(in Telefilm’s opinion) with the funding application, the project, any previously completed project, the applicant and any
related party to the applicant, including, but not limited to, an external evaluator, persons sitting on any decision making
committee for the project, actual or proposed financial partners, corporate and/or completion guarantors, interim financiers,
auditors, legal counsels, the Canada Media Fund, the Department of Canadian Heritage, CAVCO, CRTC, foreign authorities
representative(s), and other governmental entities (collectively the “Entities”). The applicant further authorizes said Entities
to discuss and disclose to Telefilm Canada any information concerning any aspect of the funding application, the project, any
previously completed project, the applicant and any related party to the applicant;

authorizes Telefilm Canada to disclose on its website any and all information pertaining to the application and/or the project,
such as the project title, genre and format, writing language and production companies;

agrees to notify Telefilm Canada immediately if and when any changes occur to any of the submitted documents and shall
provide written details of same;

declares that the applicant(s) has/(have) not entered into any oral or written agreement or side deal that conflicts with any of
the provisions of this application form, of the Mini-Treaty Television Development Agreement, of the Mini-Treaty
Information Document or of applicable Telefilm Canada business policies;

declares that the project complies and will continue to comply with the Mini-Treaty Television Development Agreement, the
Mini-Treaty Information Document and applicable Telefilm Canada business policies;
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Mini-Treaty Canada-France / French-language television / Development – Application Form
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
has made and shall make without delay full disclosure to Telefilm Canada of any dispute, actual or potential litigation in
connection with the project;

declares that all persons specified as being Canadian in the Application and all accompanying documentation, are Canadians,
in accordance with the Investment Canada Act, the Immigration and Refugee Protection Act or the Citizenship Act;

authorizes Telefilm Canada to reproduce and distribute internally to its employees and subcontractors, all material submitted
at any time in connection with the project, using any medium or support including its internal servers.
The undersigned hereby declares and warrants that the information and documents submitted for this application are
accurate, true and complete, and makes this solemn declaration knowing that it is of the same force and effect as if
made under oath.
Signature of Applicant (Canadian Producer):
I am duly authorized
Name (please print)
Title
Date (Y-M-D)
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