FICTIONAL BASED SUBJECT MATTER CONFIRMATION FORM

Updated: Nov. 1, 2025

1. What is it?

A Fictional-Based Subject Matter Confirmation Form (also called a Fiction Disclaimer Statement) is a legal declaration—typically signed by a film’s writer, producer, or rights holder—affirming that the story, characters, and events depicted in the film are entirely fictional or fictionalized, and not based on any specific real person, event, or company. This form is used to mitigate legal risks related to defamation, invasion of privacy, or misappropriation of likeness by distancing the content from any claim that it portrays real individuals or real-life entities without authorization. It is especially useful when no underlying rights agreement is needed because the project is original or the story is sufficiently fictionalized to avoid legal exposure.

2. Who is it for?

This document is relevant to anyone developing, producing, distributing, or underwriting a project that includes characters or events that might be interpreted as real—but are in fact fictional. It’s often a standard part of legal delivery to distributors or errors and omissions (E&O) insurance applications.

Common users include:

• Screenwriters submitting original scripts

• Independent producers preparing for distribution

• Studios releasing films with loosely inspired plots

• E&O insurance brokers requiring legal clearance

• Distributors or platforms requesting delivery documentation

• Attorneys overseeing rights clearance or production legal

3. What does it include?

The form is typically a one-page sworn statement confirming that the material is either wholly fictional or contains fictionalized versions of events or characters, without specific real-life counterparts. It includes clear language that no characters are based on identifiable living (or recently deceased) individuals unless separately licensed.

Key Sections Typically Include:

• Title of the Work (working title of the film or project)

• Declarant Information (name, role—e.g., producer, screenwriter, rights holder)

• Fictionalization Statement

  • Statement affirming the story is entirely fictional or fictionalized

  • Affirmation that characters are not based on identifiable real persons or entities

• Signature Block

  • Signature of declarant

  • Printed name, title, company

NOTE: The PDF's do not save while filling them out. Save your entries on a separate document and then copy and paste the text into the PDF forms. Then print them out.

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