Applicant
Title of Applicant
Title of Production
Type of Production	Select Type of Production Feature TV/Cable series/episode TV/Cable movie Commercial Other...
Production Company
Address
City
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Zip
Phone
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Email
Federal ID#
Approx. # of Crew
Approx. # of NC Cast
Approx. # of NC Extras
Total Production Budget
Estimated NC Spend
Preproduction	From To
Principal Photography	From To
Wrap	From To
Location Areas (City/Towns)
Production's Financial Contact (person who will be filing taxes/receipts with NCDOR)
Name
Address
City
State	Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip
Phone
Fax
Email