Report Deceased Musician » Beneficiary Main Menu | Film Musicians Secondary Markets Fund

First Name*

Middle Name or Initial

Last Name*

Account Number

Please enter ONLY the Last 4 digits of ALL applicable Tax ID Numbers (SSN, SIN or TIN) under which the participant may have worked.

SSN* (U.S. Social Security #)

SIN* (CAN Social Insurance #)

TIN* (U.S. Taxpayer ID #)

The deceased participant was classified as a:

Musician

Beneficiary

Both

Please enter your information below:

First Name*

Middle Name or Initial

Last Name*

Address Line #1*

Address Line #2

Address Line #3

City*

State*

Zip/Postal Code*

Country*

Relationship to Participant*

Primary Phone Number*

E-mail Address*

Report Deceased Musician Or Beneficiary