OFFICE USE ONLY
Date of Receipt:
/
/
Reference No:
/
/
□ OLD RULES
□ NEW RULES
INTERNATIONAL CO-PRODUCTION PROGRAM:
APPLICATION FOR FINAL APPROVAL
FORM B: PRODUCER OFFSET CERTIFICATION
If your project has NOT been produced as an official co-production, do not use this form.
Go to www.screenaustralia.gov.au/producer_offset/final_certification.aspx
This form is only to be completed if you wish Screen Australia to consider a project’s eligibility for
a final certificate for the Producer Offset at the same time as its final application for co-production
approval. This is optional only.
It is important to note that Screen Australia cannot issue a Producer Offset certificate until coproduction status has been approved.
THIS FORM MUST BE COMPLETED USING MICROSOFT WORD.
You can use the tab key to jump to the next field.
PROJECT TITLE:
AKA TITLE/S:
APPLICANT COMPANY:
Co-pro reference: CP.
/
(as per your provisional Co-production approval)
Is this the same company that has applied for official co-production status in Form A?
YES
NO
If NO, you must attach an ASIC search, detailing ABN, registered address, and names and addresses of company
directors for the Producer Offset Applicant Company.
Has a Producer Offset provisional certificate been issued for this project?
If yes, please provide your provisional certificate number:
/
YES
NO
/
SUBMITTING YOUR APPLICATION
 Supply all paperwork in loose leaf form, clipped together or in a document wallet. Do not bind or staple
documents together or submit paperwork in plastic sleeves or ring binders.
 Please ensure all paperwork requested on the checklist at the back of this application form is supplied.
Projects will not be assessed until a complete application is received.
 Requests to supply documents ‘in soft copy’ means either on disc (DVD or CD), or USB (PC formatted
only)
 Allow up to 12 weeks for a complete application to be assessed.

Applications will not be accepted via email and will only be logged once the hard copy has been received
Applications, including all attachments, should be sent to:
Screen Australia, Producer Offset and Co-production Unit (POCU)
Level 7, 45 Jones Street
GPO Box 3984
Ultimo NSW 2007
Sydney NSW 2001
Phone: +61 2 8113 1042 Toll free: 1800 213 099 Fax: +61 2 8113 5999
Enquiries: pocu@screenaustralia.gov.au
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INTRODUCTION
The Producer Offset legislation uses the term ‘film’ to refer to all formats of production. To avoid confusion, throughout
this application form, the term ‘project’ is used to include feature films, telemovies, television drama series,
documentaries and animation.
In order to be certified by Screen Australia as eligible for the Producer Offset, a project must meet the following criteria:





It must be completed.
Screen Australia must be satisfied that it has 'significant Australian content' or it must be an official co-production.
It must be of an eligible format.
Its qualifying Australian production expenditure (QAPE) must meet or exceed the relevant threshold.
The applicant company must be an Australian company, or a foreign company with an Australian permanent residency
and an Australian Business Number (ABN).
 The applicant company must have either carried out, or made arrangements for carrying out, all the activities
necessary for making the project.
This application form has been prepared in order to provide Screen Australia with sufficient information to determine
whether the above criteria have been met. Further information may be sought as required.
BEFORE YOU BEGIN
Please refer to www.screenaustralia.gov.au/producer_offset for:




Producer Offset Guidelines
Relevant QAPE spreadsheets
Factsheets and guidance material on Significant Australian Content and QAPE
At a Glance – a comprehensive reference document particularly useful in assisting with the calculation of QAPE
THIS FORM MUST BE COMPLETED USING MICROSOFT WORD.
You can use the tab key to jump to the next field.
PLEASE NOTE
Criminal and civil penalties apply to persons who make false or misleading statements to Screen Australia or the
Australian Taxation Office. In addition, if a certificate issued by Screen Australia was obtained by fraud or serious
misrepresentation, Screen Australia can revoke the certificate.
Screen Australia is bound by tax secrecy laws and will not disclose information provided by applicants or their
representatives otherwise than in accordance with those laws. Subject to compliance with tax secrecy laws, in the
performance of its duties as the film authority for the Producer Offset, Screen Australia may disclose certain
information to third parties notably Independent Film Production Consultants (who assist in the assessment of
applications on behalf of Screen Australia), the Australian Taxation Office, the Treasury Department and the Office
for the Arts in the Department of the Prime Minister and Cabinet.
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IMPLICATIONS OF 2011 PRODUCER OFFSET REFORMS
The Australian Government’s 2011-12 Budget included a number of proposed reforms to the Producer Offset which have
now been enacted. The reforms took affect for:
 Projects with Screen Australia production funding (investment or grant), where funding approval was given
(ie a Letter of Approval was issued) on or after 1 July 2011
 All other cases (ie projects without Screen Australia production funding), where pre-production commenced on
or after 1 July 2011
The provisions of the Producer Offset taking into account the reforms are referred to as the ‘new rules’.
The provisions of the Producer Offset taking as it existed prior to the reforms are referred to as the ‘old rules’.
Use the questions below to ascertain whether your project falls under the ‘old rules’ or the ‘new rules’.
Did the project receive Screen Australia investment?
YES*
If YES, did you receive notification of funding
approval from Screen Australia investment (ie:
Letter of Approval) on or after 1 July 2011?*
YES
NO
‘NEW
RULES’
‘OLD
RULES’
NO
If NO, did pre-production commence on your
project on or after 1 July 2011?
YES
NO
‘NEW
RULES’
‘OLD
RULES’
* If your project received Screen Australia investment, you must attach a copy of the notification of funding approval.
The changes under the ‘new rules’ affect eligibility as well as what can be counted as QAPE.
For an overview, see www.screenaustralia.gov.au/producer_offset/changes2011.aspx
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INELIGIBILITY
INELIGIBILE FORMATS
In relation to this project, if the answer is YES to any of the following questions, the project will be ineligible
for the Producer Offset.
Is the project:
 an advertising program? ................................................
YES
NO
 a commercial?...............................................................
YES
NO
 a discussion program? ..................................................
YES
NO
 a quiz program? .............................................................
YES
NO
 a panel program? ...........................................................
YES
NO
 a variety program? .........................................................
YES
NO
 a film of a public event (other than a documentary)?.....
YES
NO
 a training film?................................................................
YES
NO
 a computer game? .........................................................
YES
NO
 a news or current affair program? .................................
YES
NO
 a reality program (other than a documentary)?..............
YES
NO
INELIGIBILITY BY PREVIOUS CERTIFICATION
In relation to this project, if the answer is YES to any of the following questions, the project will be
ineligible for the Producer Offset.
1.
Has the applicant company, or any investor in the project, claimed a deduction in relation to
copyright in the project under Division 10B of Part III of the Income Tax Assessment Act 1936?
YES
NO
Has a Final Certificate for the project been issued at any time under Division 10BA of
Part III of the Income Tax Assessment Act 1936?
YES
NO
3.
Has a certificate been issued for the Location Offset or the PDV Offset?
YES
NO
4.
Has the applicant company or anyone else received investment in the project from a Film
Licensed Investment Company (FLIC)?
YES
NO
Has the applicant company received equity funding from the Film Finance Corporation,
the Australian Film Commission, Film Australia or the Australian Film Television and
Radio School, prior to July 2007 (ie: was the first drawdown pre-July 2007)?
YES
NO
Has the applicant company received any payments from the Producer Equity Program (PEP)
for this project?
YES
NO
2.
5.
6.
Answering YES to any of the following questions does not mean the project will be ineligible for the
Producer Offset tax incentive, but may have other impacts.
1.
2.
3.
Has the applicant company applied for any payments from the Producer Equity Program (PEP)
for this project?
YES
NO
Has a Provisional Certificate for the project been issued at any time under Division 10BA
of Part III of the Income Tax Assessment Act 1936?
YES
NO
Has an application been made for a certificate for the Location Offset or PDV Offset?
YES
NO
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Section B1
APPLICANT INFORMATION
Note: the fields in this form expand as you type in answers. Use the tab key to jump to the next field.
APPLICANT COMPANY (registered name):
ABN:
Registered address:
Business/Mailing address:
Contact(s) for questions during the assessment process:
1.
Role:
2.
Role:
Business phone:
Address and contact person to send the final certificate to:
Mobile phone:
Email:
Names of Company Directors
Nationality
Residency
Beneficial owners of shares in
the Applicant Company
Nationality
Residency
If the applicant company is a foreign resident, please attach details of the applicant company’s permanent establishment
in Australia.
Tick to confirm the following:
The applicant company has been responsible for the making of the project in its entirety.
The applicant company is not acting in the capacity of a trustee of a trust.
Was the applicant company set up as a Special Purpose Vehicle (SPV)
If YES, please provide details of the parent company/ies below.
PARENT COMPANY (IF APPLICABLE):
ABN:
Registered address:
Business/Mailing address:
YES
NO
Contact person:
Role of contact person:
Business phone:
Mobile phone:
Email:
Names of Company Directors
Nationality
Residency
Where a prior outgoing production company is not the Parent Company, please attach details of that company
(see At a Glance ‘Prior company expenditure’).
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Section B2
PROJECT INFORMATION
B2.1. FORMAT AND DURATION
Please select format:
Feature film
Running time (in minutes):
Feature film (large format – ie: Imax)
Running time (in minutes):
Single-episode programs (except short-form animation*)
Single-episode program (other than documentary)
Running time (in minutes):
Single-episode program (documentary)
Running time (in minutes):
Go to
2.2: Dates
overleaf
Season of a series (except short-form animation*)
Season of a series (drama/animation)
OR
Season of a series (documentary)
A series must consist of at least two episodes; and
 under the ‘old rules’ total no more than 65 episodes
 under the ‘new rules’ total no more than 65 commercial hours.
See At a Glance for further guidance on seasons of a series and new creative concepts where relevant.
For a season of a series it is mandatory to complete Worksheet (b)(1) of the QAPE spreadsheet before continuing
further.
Have you completed Worksheet (b)(1) of the QAPE spreadsheet?
YES
Using Worksheet (b)(1) as a guide please complete the following:
Season Number:
(this is the season that you are applying for)
Total commercial hours to date:
(including the season that you are apply for)
New creative concept
Under the ‘new rules’, a series (or season thereof) is deemed completed at the completion of the 65th commercial
hour of the series, including all commercial hours made prior to the commencement of the Offset.
Under the ‘old rules’, a series (or season thereof) is deemed completed at the completion of the 65th episode of the
series, including all episodes made prior to the commencement of the Offset.
However, where a series is a ‘spin-off’ from a prior series, or where a prior series is revived after a lapse of time, then
the new series may be considered to be a ‘new film’, provided that it demonstrates a ‘new creative concept’ relative to
the original series. Where this is the case, the effect is to ‘restart’ either the 65-commercial hour cap (under the ‘new
rules’) or the 65-episode cap (under the ‘old rules’).
Where relevant, see At a Glance for further guidance on what may be considered a ‘new creative concept’ and
contact the POCU if you think you need to address the legislative criteria of ‘new creative concept’.
Short-form animation*
* ie an animated drama or documentary program of one episode or a collection of episodes, of not less than one
commercial quarter hour in total duration.
No. episodes:
x actual episode length
= total actual running time
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B2.2. DATES
Date of commencement of principal photography
(or for an animated project, the date the production of the animated image
commenced):
Date of completion of the project:
NB: See At a Glance for the definition of ‘completion’.
Date that the applicant first incurred QAPE:
Date of completion of QAPE expenditure:
On air date/release date in
Australia
Via
distributor/broadcaster
Note that QAPE can only be incurred up to the end of the financial year in which the project was completed.
Does the applicant company operate under a Substituted Accounting Period (SAP)?
YES
If YES, please state the date of the ‘year end’ for the applicant company (eg 31 Dec 2012):
State which financial year the substituted accounting period is replacing (eg 2011-12):
NO
B2.3. KEY CREATIVES
Full credit listing of all production personnel with name and nationality is attached as part of Form A.
ATTACHMENTS:

Copies of fully executed contracts for all above-the-line production personnel
B2.4. CHARACTERS AND CAST
All principal characters and cast are listed in Section A5 in Form A.
Full credit listing of all cast with name, nationality is attached as part of Form A (for documentaries this must include a
narrator or on-screen presenters (if applicable), and for animated projects this must include lead voices.
ATTACHMENTS:

Copies of fully executed contracts for all above-the-line cast
B2.5. CHAIN OF TITLE AND UNDERLYING RIGHTS
The applicant company holds the appropriate rights necessary to make the project. This includes, for example, the
copyright in a screenplay and the right in any underlying work on which the screenplay is based (ie a book,
unpublished manuscript, etc).
All chain of title documents, including a solicitor’s opinion letter on chain of title (if available) are attached as part
of Form A.
Copy of script is attached as part of Form A.
Script title:
Has the script had previous titles other than the current title on the completed version of the project:
If YES, please state previous title/s:
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YES
NO
7
Section B3
AUDITED EXPENDITURE STATEMENTS & QAPE
B3.1. EXPENDITURE STATEMENTS
General requirements
The following expenditure statements for the project must be provided:
 General Ledger (GL)
 Final cost report
 Completed final QAPE spreadsheet (including all applicable worksheets).
One of the most important tasks for Screen Australia in assessing applications for final certification is to
establish that expenditure has been incurred, and in turn, what proportion of the total project expenditure is
QAPE.
The three documents the POCU rely on are outlined in detail below –
 General Ledger – this document is maintained by the applicant company and records all actual (or in some
limited cases, accrued) costs incurred by the company. It must contain the date of payment, the name of the
payee, a detailed description of the budget item and the cost of the individual item. The GL is usually created
in an accounting format such as Eclipse, Goldfinger or MYOB. It must be provided in its native accounting
format as a PDF. You may also choose to provide an Excel ‘dump down’ of your GL – this dump down must
contain category headings, sub-totals and totals. An Excel ‘dump down’ alone is not acceptable. NB: if
interested party charges total in excess of approximately 50% of the claimed QAPE for a project, applicants
must, upon request, be able to provide detailed GL for each related company that incurred costs (for that
particular project)
 Cost report – the cost report prepared for the project should represent the total actual expenditure (based
on the GL) plus accrued expenditure, plus (in some cases) ‘estimates to complete’. The ‘total final costs’ on
your cost report should match Column (A) – total project expenditure – on the QAPE spreadsheet.
 QAPE spreadsheet – this should contain all expenditure exported from the final cost report, with GST
added (under the old rules) and QAPE and non-QAPE expenditure noted.
It is vital that these three documents are consistent and reconciled. Lump sum cash payments (for example,
‘petty cash’) with little or no detail provided are not acceptable.
In some cases, if the figures do not reconcile, it may be due to an ‘expenditure in a foreign currency’ or an ATL
cap adjustment.
Cost report is attached as part of Form A.
Please address the questions below 1. Does the General Ledger match the final cost report?
2. Does the ‘total final costs’ on the final cost report match Column (A) – ‘total project expenditure’
on the final QAPE spreadsheet?
YES
NO
YES
NO
If NO, please provide a detailed explanation as to why these documents do not reconcile.
3. It is mandatory that the estimated QAPE on the Auditor’s Statement matches the FINAL QAPE on the final QAPE
spreadsheet. Please confirm that this is the case.
YES
4. Does the Cost Report contain any expenditure in either the ‘estimates to complete’ column or the ‘purchase orders’
column?
YES
NO
If YES, please supply supporting documentation (eg contract/tax invoice/purchase order)

ATTACHMENTS:


General Ledger in native format (in PDF) and (if relevant) also in Excel (SOFT COPY only)
Final QAPE spreadsheet – including all applicable worksheets (SOFT & HARD COPY).
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B3.2. QAPE
QAPE SPREADSHEET
You are required to complete a final QAPE spreadsheet. The template for the final QAPE spreadsheet is available on the
Screen Australia website at www.screenaustralia.gov.au/producer_offset
Where relevant, you are also required to complete the individual worksheets attached to the QAPE spreadsheet:
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(k)
Covering page
QAPE spreadsheet
GST (‘old rules’ only)
Expenditure in a foreign currency (if applicable)
Interested party transactions
Development expenditure breakdown
Expenditure as a foreign resident company
Expenditure on flights to and from Australia
Expenditure incurred on travel costs in other countries
Expenditure on a ‘non-Australian’ resident working both in Australia and overseas
Expenditure on an Australian resident working both in Australia and overseas.
Refer to At a Glance for information about QAPE thresholds and for guidance on what expenditure may be claimed as
QAPE.
SUMMARY (Please complete the box below – this information can be taken from the QAPE calculation
summary box on your QAPE spreadsheet)
Total Film Expenditure
(ie: production expenditure + GST if applicable)
Claimed QAPE: Feature
AUD$
Claimed QAPE: Non-feature
AUD$

AUD$
Total QAPE per hour:
ATTACHMENTS: Final QAPE spreadsheet (including all applicable worksheets) in HARD COPY and SOFT COPY.
B3.3. AUDIT
The expenditure statements must be audited by an independent Australian auditor registered as such in
accordance with the Corporations Act 2001. ‘Independent’ means that the auditor must not be an officer,
employee or partner of the applicant, or of a related body corporate of the applicant.
The auditor must sign the pro-forma Auditor’s Statement verifying claimed QAPE.
Please fill in the auditor contact details below.
Company Name:
Corporations Act 2001 Registration Number:
Contact Name:
Qualifications:
Office/Title:
Business telephone:
Mobile telephone:
Fax:
Email:

ATTACHMENTS: Auditor’s Statement using pro forma available at:
www.screenaustralia.gov.au/producer_offset/final_certification.aspx
The text must be copied and pasted onto the auditor’s letterhead before signing.
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Section B4
ADDITIONAL INFORMATION
B4.1. STATE GOVERNMENT REBATES AND REFUNDS
Did the applicant access any State Government rebates or refunds (including offsets and
excluding production investment) in relation to the production of the Project?
YES
NO
If YES, give details of such rebates or refunds rights below:
State Government:
Contact:
Job Title:
Phone:
Email:
Type of rebate or refund:
Amount: $
B4.2. DISTRIBUTION, TRANSMISSION AND BROADCAST
In order to qualify for the Producer Offset a project must be:
1. Produced for exhibition to the Australian public in a cinema or by way of television broadcasting; or
2. Produced for distribution to the Australian public as a video recording (whether on tapes, digital video discs or
otherwise).
Evidence of such distribution is a requirement for final certification.

ATTACHMENTS: Copies of fully executed Distribution or License/Broadcast Agreements (unsigned copies are
not acceptable).
FEATURE FILMS ONLY – RELEVANT RIGHTS
Please complete:
1. Were all the Australian cast members engaged under the Media Entertainment
and Arts Alliance (MEAA) Australian Feature Film Agreement (AFFA)?
YES
NO
If no, please attach a statement explaining why not.
2. Indicate which of the following ‘loading for rights’ were bought out in agreements with cast members?
World Theatrical Rights
Australian Free Television Rights
Australian Ancillary Rights
World TV Rights (excluding US Network)
World Ancillary Rights (excluding Australia)

ATTACHMENTS: Copies of fully executed contracts for all above-the-line cast.
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SUPPORTING DOCUMENTATION CHECKLIST
INSTRUCTIONS





Please confirm by marking the boxes below that the relevant attachments have been submitted.
Unless otherwise indicated by ‘SOFT COPY only’ please supply all paperwork in HARD COPY.
In some instances you are required to supply documents in both SOFT COPY and as a HARD COPY.
SOFT COPY means either on disc (DVD or CD), or USB (PC formatted only).
Supply all paperwork in loose leaf form, clipped together or in a document wallet. Do not bind or staple documents
together or submit paperwork in plastic sleeves or ring binders.
 Please collate documents in the order indicated in the checklist.
 ‘Previously supplied’ means supplied to the Producer Offset & Co-production Unit of Screen Australia in the
context of a provisional certificate application; it does NOT mean supplied to other areas of Screen Australia
such as Development or Production Investment.
B1 DOCUMENTATION: APPLICANT INFORMATION
1.
Formal company statement (eg from ASIC) providing the registered address of the Producer Offset applicant
company and the names and addresses of the directors & shareholders of the company
Attached
(SOFT & HARD COPY)
OR
(If same as applicant for Final Co-production approval) Attached to Form A
2.
Any agreements relating to the transfer of production responsibility from a previous production company or
companies (this is likely to form part of your chain of title documentation)
Attached to Form A
3.
Formal company statement (eg from ASIC) providing proof of Australian permanent residence of parent production
company: including ABN, registered address, names and addresses of directors and shareholders of the company.
Attached
SOFT & HARD COPY)
Not applicable
4.
Description of relationships between parent/associate companies, applicant company and if applicable production
services company and previous production company or companies (eg ultimate holding company).
Attached
(SOFT & HARD COPY)
Not applicable
B2 DOCUMENTATION: PROJECT INFORMATION
5.
One page synopsis
Attached to Form A
6.
For feature films and television drama – production and shooting schedules for the project’s shooting period
Attached to Form A
7.
For feature films and television drama – daily progress reports for the project’s shooting period
Attached to Form A
8.
For documentaries – a comprehensive production schedule (if no progress reports are available)
Attached to Form A
9.
Full credit listing from the completed project of all production personnel with name, nationality and residency
Attached to Form A
10. Fully executed copies of contracts for all above-the-line production personnel
Attached
(SOFT COPY only)
11. Full credit listing of all cast with name, nationality and residency prior to production. For documentaries this must
include a narrator or on-screen presenters (if applicable), and for animated projects this must include lead voices
Attached to Form A
12. Fully executed copies of contracts for all above-the-line cast
Attached
(SOFT COPY only)
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13. Copy of all chain of title documents (ie PIA, writer, script editor and director agreements, including if appropriate
(a) Supporting documents which outline all parties who have a beneficial interest in the copyright of the film, including
agreements relating to the transfer of production responsibility from a previous production company or companies
(b) Supporting documents which set out creative rights and recoupment for any non-Australians
Copy of solicitor’s opinion letter (if available)
Attached to Form A
14. Copy of the final script or bible
Attached to Form A
15. A copy of the completed project on DVD
Attached to Form A
B3 DOCUMENTATION: EXPENDITURE STATEMENTS & QAPE
Your expenditure statements must be accurate and reconciled. Please refer to Section 3.1.
16. General ledger for the project in PDF format
Attached
(SOFT COPY only)
NB: Please supply your general ledger as a PDF in its ‘native format’ – ie: in the accounting format it was created in
such as Eclipse, Goldfinger or MYOB. You may also supply an Excel dumpdown – please refer to Section 3.1 for
further details.
17. General ledger for the project in Excel format
Attached
(SOFT COPY only) Not applicable
18. Final Cost Report:
Attached to Form A
19. Supporting documentation in relation to expenditure represented in the Cost Report as either ‘purchase orders’ or
‘estimates to complete’.
Attached
(SOFT & HARD COPY)
20. Completed final QAPE spreadsheet, including all applicable worksheets
Attached
(SOFT & HARD COPY)
21. Production audit (if available) – this is the Auditor’s audit of the total production costs of the film in accordance with
the film’s budget categories and in a form satisfactory to Screen Australia. The Auditor must be a registered
Company Auditor independent of the applicant company and the producer.
Attached to Form A
Not applicable
22. Auditor’s Statement provided based on the required pro-forma (the Auditor must be a registered Company Auditor
independent of the applicant company and the producer).
Attached
(SOFT & HARD COPY)
23. A schedule detailing the fees and residuals paid out to each individual cast member before completion of the project
– where the cast member’s remuneration is QAPE.
Attached
(SOFT COPY only) Not applicable
24. A schedule detailing non-recoverable advances paid to each individual cast member – where the cast member’s
remuneration is QAPE.
Attached
(SOFT COPY only) Not applicable
25. Interested Party Breakdown – provide a list with the names of all companies (as identified in the expenditure
statements) that provided goods/services in making the project that are associated with the applicant company or
any of its associated entities. This can be achieved by completing Worksheet (e) on the final QAPE spreadsheet)
Attached (SOFT & HARD COPY)
Not applicable
26. Invoice/breakdown of insurance costs from insurance company clearly outlining the insurance item and cost,
confirming the split between QAPE and non-QAPE
Attached
(SOFT & HARD COPY) Not applicable
N/A – project falls under ‘new rules’
27. Invoice/breakdown of legal costs from your lawyer, clearly outlining what work was carried out in relation to financing
and what work was carried out in relation to production
Attached
(SOFT & HARD COPY) Not applicable
N/A – project falls under ‘new rules’
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28. Invoice from the company auditor confirming the split between the work carried out on the production audit and the
work carried out on the QAPE audit
Attached
(SOFT & HARD COPY) Not applicable
N/A – project falls under ‘new rules’
29. If you are claiming the cost of purchasing/licensing archival footage/music copyright please provide both the invoices
and the underlying licence agreements.
Attached
(SOFT & HARD COPY) Not applicable
30. Detailed breakdown of development expenditure (this can be achieved by completing Worksheet (f) on the final
QAPE spreadsheet).
Attached
(SOFT & HARD COPY) Not applicable
31. Detailed breakdown of publicity expenditure (please provide if you are claiming costs associated with publicity as
QAPE (in most cases, the publicist’s contract will suffice).
Attached
(SOFT & HARD COPY) Not applicable
N/A – project falls under ‘new rules’
32. Evidence and dates of any development expenditure (including the script) incurred outside of Australia.
Attached
(SOFT & HARD COPY) Not applicable
OTHER SUPPORTING DOCUMENTS
33. If your project received Screen Australia investment, please provide a copy of the funding approval letter
Attached
(SOFT & HARD COPY)
Not applicable
34. Fully executed Distribution, License or Broadcast Agreement (an unsigned copy is not acceptable).
Attached
(SOFT COPY only)
35. A statutory declaration made by the Australian co-producer to confirm that all information now being supplied to
Screen Australia in relation to the application for a Final Certificate for the Producer Offset is accurate and that all
information previously supplied to Screen Australia and which remains unchanged is also accurate. See the form of
statutory declaration attached
Attached
(SOFT & HARD copy)
Document1
CO-PRODUCTION FINAL APPLICATION FORM - FORM B, OFFSET – October 2013
13
STATUTORY DECLARATION
I, __________________________________________, ______________________________________,
(Name of Authorised signatory on behalf of the applicant company,
Role of Authorised Signature
of
____________________________________________
____________________________________________,
(address of Authorised signatory,)
do solemnly and sincerely declare on behalf of
______________________________________
(Name of applicant company)
that this Statutory Declaration is made for Rule 17 of the Producer Offset Rules 2007 and that the
information contained in the application for a Final Certificate, and the documents attached to it, is correct
and true in every particular and I make this solemn declaration by virtue of the Statutory Declarations Act
1959, and subject to the penalties provided by that Act for the making of false statements in statutory
declarations, conscientiously believing the statements contained in this declaration to be true in every
particular.
Signature of applicant ______________________________________________
Declared at ______________________________________________________
On the ___________ day of ______________________, 20___
Before me,
Signature _______________________________________________________
Name
_______________________________________________________
(please print full name)
Qualification _____________________________________________________
Address _________________________________________________________
___________________________________________________________
Note: A penalty of imprisonment for four years applies to the offence of making a false statement in a
Statutory Declaration.
A full list of prescribed persons before whom a Statutory Declaration may be made is available from the
Department while the legislation governing this provision can be sourced online from the Federal
Government’s legal information retrieval database at
http://www.ag.gov.au/Publications/Pages/Statutorydeclarationsignatorylist.aspx
Document1
CO-PRODUCTION FINAL APPLICATION FORM - FORM B, OFFSET – October 2013
14