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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

 

Check one or both of the requests below:

  _
/_/        I am requesting that the Film Musicians Secondary Markets Fund mail a new musician beneficiary designation card to me.
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/_/        I am requesting that the Film Musicians Secondary Markets Fund inform me, by phone, of my beneficiary designation(s).

IMPORTANT-PLEASE READ

In order to make any updates to your beneficiary designation(s), or to find out your beneficiary designation(s), 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 or phone call.

Be sure to direct your fax, or mailing, to the Beneficiary Claims Department, attention John Felikian, Sr. Beneficiary Claims Specialist – (818)755-7777, Ext. 833.

IMPORTANT: We will hold your completed request form for a period of 60 days.  If we do not receive your completed beneficiary designation card within the next two months, for security reasons, we will shred this form.

 

Today’s Date: _____________________

 

Participant Musician Name: _________________________________________________

 

Mailing Address: _________________________________________________________

 

Phone #: _________________________

 

Last 4 Digits SSN / Fund Acct. #____________________________________________

 

 

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              Participant Musician Signature

 

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