APPLICATION FOR AN ISMN PUBLISHER PREFIX

	INTERNATIONAL STANDARD MUSIC NUMBER--UNITED STATES AGENCY International Standard Numbering System for the Information Industry 630 Central Avenue, New Providence, New Jersey 07974 FAX: 908-219-0188 Email: ismn@bowker.com
International Standard ISO 2108	R.R. Bowker LLC, a Cambridge Information Group company

PLEASE PRINT OR TYPE: Company/Publisher Name: ________________________________________________________ Address: _______________________________________________________________________ City: _________________________________ State: _______________ Zip: ____________ Phone Number: ______________________________________________ DO NOT PUBLISH: ___ Fax Number: ________________________________________________ DO NOT PUBLISH: ___ Toll Free Number: ______________________________________________________________ E-MAIL: ____________________________________________________ DO NOT PUBLISH: ___ Web Site: ______________________________________________________________________ Fax-on-Demand: __________________________ Toll Free Fax: _______________________ If P.O. Box Indicated, Local Street Address is Required:

You must provide one publishable address; application will not be processed without this information. Name of Rights and Permissions Contact: ________________________________________ Title: ________________________________ Phone Number: __________________________ Name of ISMN Coordinator/Contact: ______________________________________________ Title: ________________________________ Phone Number: __________________________ Division/Subsidiary of: ________________________________________________________ (circle which one and provide company name) Imprints: ______________________________________________________________________ PUBLISHING INFORMATION: Indicate year you started publishing: __________________________________________ DISTRIBUTION INFORMATION: 1. Do you distribute for, or are you distributed by, any other company? Yes: __________ No: __________. If yes, please provide full company name, address and ISMN Publisher Prefix (if any): _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

PAYMENT: A NON-REFUNDABLE PROCESSING SERVICE CHARGE (Service charge fees are subject to change) SINGLE ISMNS ARE NOT AVAILABLE PRIORITY PROCESSING SURCHARGE $50 ISMN PREFIX BLOCK PRIORITY PROCESSING FEE REGULAR PROCESSING FEE 10 ISMNs $250.00 _____ $200.00 _____ 100 ISMNs $550.00 _____ $500.00 _____ 1,000 ISMNs $850.00 _____ $800.00 _____ 10,000 ISMNs $1,250.00 _____ $1,200.00 _____ __ Check/Money Order enclosed. Make payable to "R. R. Bowker." __ Charge: ____ American Express ____ Visa ____ Master Card ____ Discover Card Holder Name: ______________________________________________________________ Account #: __________________________ Expiration Date: __________________ Total amount enclosed or charged: ______________________________________________ Authorized signature: ________________________________ Date: ___________________ * Note: Credit Cards are the preferred form of payment Bowker does not charge Sales Tax

PROCESSING INFORMATION:

Your application for an ISMN Publisher Prefix will be processed ONLY if you include the following:

Completed application
Payment

* Note: Credit Cards are the preferred form of payment

The ISMN U.S. Agency will not provide an ISMN by telephone or fax. Processing time for an ISMN application is 10 full business days (Saturdays and Sundays and Holidays are not business days) from the date of receipt (provided there are no problems with the application).

PRIORITY PROCESSING:

If you intend to ask the agency for a faster turn around time, a priority charge of $50. applies and must be added to the service charge fee. Priority service includes return, within 72 business hours of receipt (provided there are no problems with the application).

If you are requesting priority service and would like your ISMN log book e-mailed, please provide the e-mail address to where it should be sent: _______________________

Please Note: The priority service is either by e-mail or courier service, but NOT both.

                    ______________________________________
                    Return the application and payment to:

                    ISMN U.S. Agency
                    R.R. Bowker
                    630 Central Avenue
                    New Providence, NJ 07974
                    FAX: 908-219-0188
                    ismn@bowker.com