Royalty Payment Termination Notice Form
Use this Royalty Payment Termination Notice Form to formally notify a party that royalty payments should cease as of a specified date. Please complete all fields accurately.
Notifying Party Name
*
First Name
Last Name
Notifying Party Email Address
*
example@example.com
Notified Party Name
*
First Name
Last Name
Notified Party Email Address
*
example@example.com
Agreement or Contract Reference
*
Effective Date of Termination
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Royalty Payment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Termination
*
Additional Remarks or Instructions
Signature of Notifying Party
*
Submit Notice
Submit Notice
Should be Empty: