PROJECT INFORMATION FORM - TELEVISION This Project Information Form (PIF) should be filled out by an existing Directors Guild of America signatory company for each new television project or by a company requesting DGA signatory status. Please note that more detailed information may be required pending review by the Guild. Submission of this form does not constitute signatory acceptance. Please print clearly: Signatory Company: ______Company Contact: ______Phone : ______E-Mail: ______Project Title: ______Copyright Holder :______Contact: ______Phone :______Writer/s :______

Budget: (U.S. dollars ) $ ______Location/s: ______Start Dates: Pre-Production:______Principal Photography:______Wrap: ______Format : ‘ Multi-Camera ‘ Single Camera Produced : ‘ Digital ‘ Film ‘ Tape ‘ Live ‘ Other:______

Program Type : ‘ Dramatic ‘ Sitcom ‘ Reality Program Length ( minutes ): ‘ 30 ‘ 60 ‘ 90 ‘ 120 ‘ Variety ‘ Other ( explain ):______‘ Other (specify) :______INITIAL RELEASE (check one, indicate station or network not listed): Is this a Pilot? : ‘ Yes ‘ No ‘ Network: ‘ ABC ‘ CBS ‘ FOX ‘ NBC ‘ PBS ‘ UPN ‘ WB ‘ Syndication (company name) : ______‘ Basic Cable: ‘ A&E ‘ Disney Channel ‘ Lifetime ‘ MTV ‘ Nickelodeon ‘ TNT ‘ USA ‘ Other:______‘ Pay TV : ‘ HBO ‘ Showtime ‘ TMC ‘ Starz! ‘ Cinemax ‘ Other:______‘ Direct-to-Video ‘ Other (please explain) :______EMPLOYEE INFORMATION (Please print clearly): Print Full Name: Dramatic Live & Tape Director Director 9 UPM 9 Associate Director 9 1 st Assistant Director 9 Stage Manager 9 Key 2 nd Asst. Dir. 9 2 nd Stage Mgr. 9 2 nd Second Asst. Dir. 9 3 rd Stage Mgr. 9 Add’l Second Asst. Dir. 9 Production Assoc. 9 Assoc. Dir. Other: 9 Assoc. Dir. (line cut) CONTACTS : Other Employment Contact (name) : ______Phone: ______Affiliations Residuals Contact (name) : ______Phone: ______(check all that apply): SECURITIES INFORMATION : Source of Primary Financing (required ): ______‘ SAG ‘ WGA Contact:______Phone: ______‘ DGC Completion Bond Company : ______‘ AFTRA Contact:______Phone: ______‘ IATSE Payroll Company : ______‘ NABET Contact:______Phone: ______‘ AFM ‘ ACTRA Revolving Line of Credit ?: ‘ Yes ‘ No Bank :______‘Other: Contact:______Phone: ______

List all companies holding a security interest (attach a separate sheet if necessary ): Company:______Contact: ______Company:______Contact: ______DISTRIBUTION INFORMATION : Foreign Distributor/s:______DomesticDistributor/s:______This PIF must be signed by an authorized OFFICER, OWNER, or PARTNER of the Company : Signature:______Title (print) : ______Print Name: ______Phone: ______Date: ______