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Release Form #3
Thursday, Feb 1, 2007
Date: __________, 2001

Title of Material Submitted: "________________________________"

Production company
City, state, ZIP

Dear Production company:

I am today submitting, for possible use by you, my material identified above (the "Material") in accordance with the understanding and subject to the conditions set forth herein. I assert and acknowledge that the Material was created and written by me without any suggestion or request from you that I write or create the Material. I have attached a copy of the Material hereto (and/or have synopsized it herein). I am executing and submitting this letter in consideration of your agreement to review the Material with the express understanding that I limit my claim of rights to the features of the Material as specifically synopsized or as attached hereto.

1. Except as otherwise specifically stated herein, I warrant and represent:

a) that the Material is wholly original to me;

b) that I own all rights to the Material and have the exclusive right to grant all rights in the Material; and

c) I have exclusive rights in the title, if any, as regards its use in connection with the Material.

2. You agree that you will not use the Material unless you shall first negotiate with me the terms and conditions for such use, but I understand and agree that your use of the Material or of material containing features and elements similar to or identical with those contained in the Material shall not obligate you to negotiate with me or entitle me to any compensation, if you determine, in your sole discretion, that you have an independent legal right to use such other material which is not derived from me (either because such features and elements were not new or novel, or were not originated by me, or because other persons have submitted or may hereafter submit material containing similar or identical features and elements which you have the right to use.)

3. If you determine that you have an independent legal right to this Material or to use material containing features and elements similar or identical to those contained in the Material, without payment or compensation to me, and you, or any other related entity which you own or control, or your assignee proceed to use the same, and if I disagree with your determination, I agree that if you so elect, the dispute between us shall be submitted to arbitration. The arbitrator shall be a person experienced in the field in which the alleged use was made by you, and shall be mutually agreed upon by you and me. If we cannot agree on an arbitrator, then one shall be chosen by the rules of the American Arbitration Association. The arbitration shall be controlled by the terms of this letter and any award favorable to me shall be limited to the fixing of compensation which shall bear a reasonable relation to compensation normally paid by you for similar material submitted by writers of similar stature. Of course, if you do not select to submit any such dispute to arbitration, understand that I shall be entitled to commence legal action against you.

4. I recognize and agree that affiliates of yours (including but not limited to independent producers contractually affiliated with you) may read and review this Material either in lieu of or in addition to you in satisfaction of your obligations hereunder. I further acknowledge that your rights hereunder shall apply to you, and to any of your affiliates as well, and each such affiliate shall have the same rights as you hereunder.

5. I have retained a copy of the Material, and you shall not be responsible for its preservation or return. I further release you from any claims or liability regarding loss or damage to the copy submitted by you.

6. I understand that this letter constitutes our entire understanding regarding this matter and that I am not relying on anything outside this agreement in making this submission. Any modification of these terms must be made in writing signed by both parties. With the exception of Exhibit "A", this agreement covers all additional submissions made by me now or in the future. I have completed "Exhibit A" attached hereto and incorporated herein by this reference.

Very truly yours,









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