DA Form 3238 Request for Copyright Clearance on Musical or Dramatic Works

DA Form 3238 - also known as the "Request For Copyright Clearance On Musical Or Dramatic Works" - is a United States Military form issued by the Department of the Army.

The form - often mistakenly referred to as the DD form 3238 - was last revised on September 1, 2006. Download an up-to-date fillable PDF version of the DA 3238 down below or look it up on the Army Publishing Directorate website.

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REQUEST FOR COPYRIGHT CLEARANCE ON MUSICAL OR DRAMATIC WORKS
For use of this form, see AR 215-1; the proponent agency is OACSIM
NOTE: This form is to be completed by Army Entertainment Program Managers only.
PART A - TO BE COMPLETED BY THE REQUESTING INSTALLATION
(In triplicate)
TO:
FROM:
1.
2.
(Include ZIP Code)
COMMANDER
FMWRC
(ATTN: IMWR-SR)
4700 KING STREET (Summit Centre)
ALEXANDRIA, VA 22302-4418
3. Under the provision of AR 215-1, request copyright clearance on the following work for production at this installation, or as indicated.
a. NAME OF WORK TO BE PERFORMED
b. NAMES OF AUTHORS OR COMPOSERS
c. TOTAL NUMBER OF PERFORMANCES
d. MONTHS/YEAR
e. NAME AND DSN/COMMERCIAL TELEPHONE NUMBER OF PRODUCING OR SUPERVISING ENTERTAINMENT PROGRAM MANAGER
4. TYPE OF PRODUCTION GROUP (Check all appropriate items)
5. NAME AND MAILING ADDRESS OR PRODUCING
ORGANIZATION, IF OTHER THAN 2 ABOVE
ARMY ENTERTAINMENT
MILITARY TOURING COMPANY
DEPENDENT SCHOOL
CIVILIAN TOURING COMPANY
DINNER THEATRE
OTHER
(Specify)
6. ADMISSION CHARGES (When applicable indicate Adult, Youth, etc. prices)
a. SHOW ONLY
(ADULT $
: CHILD $
: STUDENT $
)
b. DINNER AND SHOW
(ADULT $
: CHILD $
: STUDENT $
)
PROCEEDS WILL BE DONATED TO A CHARITY (Attach detailed explanation)
7. PERFORMANCE SCHEDULE
(Complete one line for each different performance site. If there are different performance sites, list separately. If needed, attach plain
bond paper, providing data required in (a) through (f), below)
If the production is commercially contracted, the terms of the contract must be fully explained on attached documentation or a copy of the contract may be attached.
NAME OR TYPE OF FACILITY
AVERAGE
EXACT DATES OF
EXACT GEOGRAPHIC
USED AS PERFORMANCE
SEATING
EXPECTED
SITE
PERFORMANCES
LOCATION
SITE
CAPACITY
ATTENDANCE
(a)
(b)
(c)
(d)
(e)
(f)
1.
2.
3.
4.
5.
8. REHEARSAL OR PRODUCTION MATERIALS REQUIRED
(Include orchestration size.) If additional space is needed, attach plain bond paper with
date. If no materials are required, indicate reasons why and attach invoices, receipts, or other proof of purchase or rental.
a. ITEM
b. SOURCE
c. DATE NEEDED
(s)
(Agency and Address)
9. SIGNATURE OF ENTERTAINMENT PROGRAM MANAGER/COPYRIGHT CONTROL OFFICER
DATE
DA FORM 3238, SEP 2006
JUNE 2004 EDITION MAY BE USED.
APD LC v1.01ES
REQUEST FOR COPYRIGHT CLEARANCE ON MUSICAL OR DRAMATIC WORKS
For use of this form, see AR 215-1; the proponent agency is OACSIM
NOTE: This form is to be completed by Army Entertainment Program Managers only.
PART A - TO BE COMPLETED BY THE REQUESTING INSTALLATION
(In triplicate)
TO:
FROM:
1.
2.
(Include ZIP Code)
COMMANDER
FMWRC
(ATTN: IMWR-SR)
4700 KING STREET (Summit Centre)
ALEXANDRIA, VA 22302-4418
3. Under the provision of AR 215-1, request copyright clearance on the following work for production at this installation, or as indicated.
a. NAME OF WORK TO BE PERFORMED
b. NAMES OF AUTHORS OR COMPOSERS
c. TOTAL NUMBER OF PERFORMANCES
d. MONTHS/YEAR
e. NAME AND DSN/COMMERCIAL TELEPHONE NUMBER OF PRODUCING OR SUPERVISING ENTERTAINMENT PROGRAM MANAGER
4. TYPE OF PRODUCTION GROUP (Check all appropriate items)
5. NAME AND MAILING ADDRESS OR PRODUCING
ORGANIZATION, IF OTHER THAN 2 ABOVE
ARMY ENTERTAINMENT
MILITARY TOURING COMPANY
DEPENDENT SCHOOL
CIVILIAN TOURING COMPANY
DINNER THEATRE
OTHER
(Specify)
6. ADMISSION CHARGES (When applicable indicate Adult, Youth, etc. prices)
a. SHOW ONLY
(ADULT $
: CHILD $
: STUDENT $
)
b. DINNER AND SHOW
(ADULT $
: CHILD $
: STUDENT $
)
PROCEEDS WILL BE DONATED TO A CHARITY (Attach detailed explanation)
7. PERFORMANCE SCHEDULE
(Complete one line for each different performance site. If there are different performance sites, list separately. If needed, attach plain
bond paper, providing data required in (a) through (f), below)
If the production is commercially contracted, the terms of the contract must be fully explained on attached documentation or a copy of the contract may be attached.
NAME OR TYPE OF FACILITY
AVERAGE
EXACT DATES OF
EXACT GEOGRAPHIC
USED AS PERFORMANCE
SEATING
EXPECTED
SITE
PERFORMANCES
LOCATION
SITE
CAPACITY
ATTENDANCE
(a)
(b)
(c)
(d)
(e)
(f)
1.
2.
3.
4.
5.
8. REHEARSAL OR PRODUCTION MATERIALS REQUIRED
(Include orchestration size.) If additional space is needed, attach plain bond paper with
date. If no materials are required, indicate reasons why and attach invoices, receipts, or other proof of purchase or rental.
a. ITEM
b. SOURCE
c. DATE NEEDED
(s)
(Agency and Address)
9. SIGNATURE OF ENTERTAINMENT PROGRAM MANAGER/COPYRIGHT CONTROL OFFICER
DATE
DA FORM 3238, SEP 2006
JUNE 2004 EDITION MAY BE USED.
APD LC v1.01ES
PART B - TO BE COMPLETED BY FMWRC
TO:
FROM:
13. DATE
11.
(Name and address of leasing agency, including ZIP
12.
Code)
COMMANDER
FMWRC
ATTN: IMWR-SR
ALEXANDRIA, VA 22331-0510
14. This is a request for copyright clearance of the work described in Part A which is scheduled for presentation under auspices of the Army
Entertainment Program on the dates and at the places indicated. You are requested to complete Part C and return the completed form to the
address entered in block 15.
a. REMARKS
b. SIGNATURE
PART C - TO BE COMPLETED BY THE LEASING AGENCY
TO:
FROM:
15.
17. DATE
16.
(Include ZIP Code)
COMMANDER
FMWRC (ATTN: IMWR-SR)
4700 KING STREET (Summit Centre)
ALEXANDRIA, VA 22302-4418
18a.
Permission is granted based on information furnished. Invoices for royalties and other fees quoted herein will be sent to FMWRC.
See Block 15.
18b.
Permission
18c. Special Remarks
19. SIGNATURE
PART D - TO BE COMPLETED BY FMWRC
TO:
FROM:
20.
21.
COMMANDER
FMWRC
(ATTN: IMWR-SR)
4700 KING STREET (Summit Centre)
ALEXANDRIA, VA 22302-4418
22a. Clearance for the requested copyrighted work is not granted by the leasing agent as indicated in PART C, above.
22b. If copyright clearance is granted, the requesting activity must complete Part E within 5 working days of the final performance and return the
completed form to the address entered in block 25.
23. SIGNATURE
24. DATE
PART E - TO BE COMPLETED BY THE PERFORMING INSTALLATION
25.
TO:
FROM:
26.
COMMANDER
FMWRC (ATTN: IMWR-SR)
4700 KING STREET (Summit Centre)
ALEXANDRIA, VA 22302-4418
27. NAME OF WORK
PERFORMED:
28a. TOTAL NUMBER OF
28b. PERFORMANCES ADDED TO OR
28c. TOTAL BOX OF OFFICE
PERFORMANCES:
CANCELLED FROM BLOCK 3c:
INCOMEFICE INCOME:
28d. TOTAL ATTENDANCE:
28e. NUMBER OF PARTICIPANTS INVOLVED
(cast, crews, orchestra and all others)
28f. APPROXIMATE NUMBER OF HUMAN RESOURCE HOURS INVESTED IN THE
(1) MILITARY
(2) NON-MILITARY
PRODUCTION:
29. SIGNATURE OF ENTERTAINMENT PROGRAM MANAGER/COPYRIGHT CONTROL OFFICER
30. DATE
APD LC v1.01ES
REVERSE OF DA FORM 3238, SEP 2006
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