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APPENDIX GINDEPENDENT PRODUCTION AGREEMENT 2012-2014 (Article A1110)STATEMENT OF DISTRIBUTORS’ GROSS REVENUEALL PRODUCTIONSSection Distributors’ Gross RevenuePre-Sales: (Article C1103(c))Specify Source_______________________________________________Specify Source_______________________________________________Specify Source_______________________________________________$__________$__________$__________ $__________ Distribution Revenue:Received by the Producer: (Specify Name)__________________________________________From Regular Distribution (From List of Distribution Territories, Section )$__________From Package Exploitation (Article A1110 (v)) (Section )$__________From Treaty Co – Production (Section )$__________From Collective Societies and Similar Agencies$__________ $__________ Received by the Head Distributor: (Specify Name)____________________________________From Regular Distribution (From List of Distribution Territories, Section )$__________From Package Exploitation (Article A1110 (v)) (Section )$__________From Treaty Co – Production (Section ) $__________ $__________Received by Sub Distributors:(Specify Name)_____________________________________(Specify Name)_____________________________________(Specify Name) ____________________________________From Regular Distribution(From List of Distribution Territories, Section )$__________From Package Exploitation (Article A1110 (v)) (Section )$__________From Treaty Co – Production (Section ) $__________ $_________ Other Revenue:Compact Devices (Article C1103(d)):Typical Sell-Through $______________ X 20% $__________Less than Typical Sell-Through $______________ X 10% $__________ $__________ Other Revenue Streams:Specify_____________________________________________________ $__________Specify_____________________________________________________ $__________Specify_____________________________________________________ $__________ $__________ Total Distributors’ Gross Revenue (To Line A, Section , Page 1)$__________Appendix G Page 2192