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## Annex III - Declaration on the list of pre-existing rights 15 

I, [ insert name of the authorised representative of the contractor ] representing [ insert name of the contractor ] (‘the contractor’) , party to the direct contract [ insert title and number ] 

[ option 1:  warrant that the results are free of rights or claims from creators or from any third parties for any use the contracting authority may envisage and declare that the results do not contain any pre-existing rights to the results or parts of the results or to pre-existing materials as defined in the above-mentioned contract.] 

[ option 2:  warrant that the results and the pre-existing material incorporated in the results are free of rights or claims from creators or from any third parties for any use the contracting authority may envisage and declare that the results contain the following pre-existing rights:] 

[ Contractor to complete if option 2 selected ]  Please fill in the table –  one line per pre-existing right 

<img src='content_image/507310.jpg'>

In addition, the creators transferred all their relevant rights to the results to [the contractor] [ insert name of the rights holder ] through [an agreement] [an employment contract] [a relevant extract of] which is attached to this statement. 

The creators [received all their remuneration on [ insert date ]] [will receive all their remuneration as agreed within [ complete ] weeks from [delivery of this statement] [receipt of confirmation of acceptance of the work]. 

Signature: 

Place: 

Date: 

