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FILM MUSICIANS SECONDARY MARKETS FUND
12001 VENTURA PLACE, SUITE 500, STUDIO CITY, CA 91604
PHONE: 818.755.7777            FAX: 818.755.7778 WEBSITE: www.fmsmf.org

Musician Beneficiary Designation Request Form

I am requesting that the Film Musicians Secondary Markets Fund mail me a new musician beneficiary designation card.

IMPORTANT-PLEASE READ

In order to make any updates to your beneficiary designations, you must fax or mail in this request form completed, signed and dated.  Failure to do so will result in the return of this form and a delay in receiving your new musician beneficiary designation card.

Be sure to direct your fax, or mailing, to the Beneficiary Claims Department, attention John Felikian, Sr. Beneficiary Claims Specialist.

 

Today’s Date: _____________________

 

Participant Musician Name: _________________________________________________

 

Mailing Address: _________________________________________________________

 

Phone #: _________________________

 

Last 4 Digits SSN: ________________________________________________________

Or

Fund Acct. #: ____________________________________________________________

 

____________________________________
Participant Musician Signature

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