Film Omission Claim Form

Use the form below to report an omission of all or part of your credited work on a film or TV title. Please note that an omission can only be verified by the submission of a B7, B4 or B8 session report form to participantservices@fmsmf.org.

Please read important policy information under Credit for Full and Partial Film Omissions - Prospective & Retroactive Payments regarding omissions and submitting a claim [here]

Fields with an asterisk * are required.

First Name*

Middle Name or Initial

Last Name*

Please enter ALL the Tax ID Numbers (SSN, SIN, and/or TIN) under which you may have worked. Be sure to enter ONLY the Last 4 digits of your relevant Tax ID(s) (SSN/SIN/TIN), no dashes.

Your SSN* (U.S. Social Security #)

Your SIN* (CA Social Insurance #)

Your TIN* (U.S. Taxpayer ID #)

Street Address

City

State/Province

Zip/Postal Code

Email Address*

Phone Number*

AFM Local #

*Film/TV Title Producer/Employer *Film/TV Release Year Instrument/Service Perf.

(Indicate instrument played and/or service performed: sideline, copyist, leader, composer, contractor, new-use, etc.)

TV Series Episode Title TV Series Episode Date *Original Score or New Use Original Score New Use (Pre-recorded song used in film or TV title)

Comments and/or Additional Information

(Indicate production dates, city where scored, if you've received a residual payment in the past, etc.)

Fill out the information above, and then click 'Submit' to make inquiries regarding specific films.

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Film Omission Claim Form