Providing service and support to film and television musicians.

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Report Deceased Musician

Residual Claim Questionnaire:

This form should be used to report a deceased FMSMF/LTVF Musician or Beneficiary.

* = Required fields


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

(U.S. Social Security #)
(CAN Social Insurance #)
(U.S. Taxpayer ID #)
(mm/dd/yyyy)

The deceased participant was classified as a:

Musician
Beneficiary
Both

Deceased Participant Information:

YES
NO
UNKNOWN
YES
NO
UNKNOWN
YES
NO
YES
NO
UNKNOWN
YES
NO
UNKNOWN
YES
NO
UNKNOWN

Please enter your information below:



By typing my name below I agree under penalty of perjury that the aforementioned is true and correct to the best of my knowledge.