FORM NO.CST.6
THE COPYRIGHT SOCIETY OF TANZANIA, COSOTA
THE COPYRIGHT AND NEIGHBOURING RIGHTS ACT, 1999
(NO. 7 OF 1999)
INDIVIDUAL MEMBER ANNUAL SUBSCRIPTION FORM
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Fee 10,000
(Made under Regulations 7)
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PART I
Name of Artist/Copyright owner………………………………………………………
Pseudonym (if any)………………………………………………………………………..
COSOTA REG. Number……………………………………………………………………
IPI number……………………………………………………………………………………
Date and year of birth…………………………………………………………………….
Place of birth…………………………………………………………………………………
Nationality…………………………………………………………………………………….
Contact address, P.O. Box ……………………………………………………………..
Tel…………………………………………………………���.
Fax……………………………………………………………
E mail ………………………………………………………
Last year’s payment receipt number …………………………….., dated…………………
Signature ……………………………………… date ………………………………………………..
PART II
*For official use only*
Checked by:
Name of officer……………………………………………………………………………………………
Designation…………………………………………………………………………………………………
Signature …………………………………………………………………………………………………..
Date ………………………………………………………………………………………………………….
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