AMERICAN FEDERATION OF MUSICIANS REPORT FORM
AMERICAN FEDERATION OF MUSICIANS REPORT FORM
TELEVISION AND RADIO COMMERCIAL ANNOUNCEMENTS
RPNo.
.
DATE:
ADVERTISER:
PRODUCT:
ADVERTISING AGENCY:
AGENCY REP.:
AGENCY ADDRESS:
AGENCY REP. PHONE:
(a) LOWEST No. OF REPORTED HRS. WK’D:
(b) No. OF ANNOUNCEMENTS CLAIMED:
One announcement may be claimed for every 20 minutes reported in (a) above, subject to a maximum of 8 announcements for synthesizer-only sessions.
IDENTIFICATION Titles and Code Nos. (Include track length for original sessions only.) When identification changes give prior and new.
Original (or Prior) TRK
Identification LGTH New Identification
A.
B.
C.
D.
E.
F.
G.
First Air Date:
Cycle Dates Being Paid:
ORIGINAL SESSION AFM Local No.:
Recording Date: No. of Musicians:
Recording Studio:
City: State:
Hours of Employment:
Music Prod. Co. Name:
RE-USE, DUBBING, NEW USE OR OTHER
Original Report Form No.:
Original Recording Date:
Check 1 and only 1 from each of these three columns.
Payment Type Medium Rates
Original Session TV National
Initial Use Radio (13 weeks) Foreign
Re-Use Radio (8 weeks) Regional (Nat’l Adv.)
New Use Non-Broadcast Regional (Reg. Adv.)
Dubbing Videocassette Local (Nat’l Adv.)
Dubbing (Longer/ Internet Local (Local Adv.)
Shorter Version) Other Indicate region or
Other local area in MEMO box
Additional Info Check Here If
Short Term Use Commercial made for cable only
Info Changes PSA status confirmed by AFM
Mech. Edit Session performed solely on synthesizer
Sideline Session Late Penalties Included
Other
MEMO
SIGNATORY OF RECORD
FOR SESSION PAYMENTS (e.g. Music Prod. Co., Agency): Address:
Pension Contributions To Be Paid By (if different):
FOR ALL OTHER PAYMENTS (e.g. Agency): Address:
Pension Contributions To Be Paid By (if different):
The terms and conditions of the engagement covered by this Report Form include the terms and conditions of the AFM Commercial Announcements Agreement in effect at the time of such engagement.
Signatory of Record’s Signature: Leader’s Signature:
Print Name of Signer: Phone: Leader’s Phone:
| | | | | | | |(1) | | |
|LOCAL | | | |NO. |SPOT |ID | | | |
|UNION |EMPLOYEE’S NAME |SOCIAL |HRS. |OF |ID by |of | | |H&W |
|NO. |(As on Social Security Card) |SECURITY |WK’D |DBL |letter |SPOT | |PENSION |WHERE |
|----------|LAST FIRST |NUMBER | |PER |above |PER |WAGES | |APPLICABLE |
|CARD |INIT. | | |SESS | |DBL |- - - - - - - - - -| | |
|NO. |(Instrument(s)) | | | | | |- - - - | | |
| | | | | | | |CARTAGE | | |
| |(LDR) | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| | | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| | | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| | | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| | | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| | | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| | | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| |(ARR) | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| |(ORC) | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| |(COPY) | | | | | | | | |
| | | | | | | | | | |
|--------- | | | | | | |- - - - - - - - - -| | |
| | | | | | | |- - | | |
| | | | | | | | | | |
| | | | |TOTAL PENSION CONTRIBUTIONS | | |
| | | | |TOTAL H & W CONTRIBUTIONS | | |
-----------------------
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FOR FUND USE ONLY:
(1) Insert X if wages being pain are overscale.
PAYMENTS NOT MADE ON A TIMELY BASIS ARE SUBJECT TO THE LATE PAYMENTS PROVISION OF THE AFM TELE䥖䥓乏䄠䑎删䑁佉䌠䵏䕍䍒䅉⁌乁低乕䕃䕍呎⁓䝁䕒䵅久⹔ㄨ
湉敳瑲堠椠慷敧慰摩愠敲漠敶獲慣敬മ湉汣摵污畭楳牰灥湩潦浲瑡潩湯琠楨潦浲漠潣瑮湩慵楴湯猠敨瑥楷桴挠VISION AND RADIO COMMERCIAL ANNOUNCEMENTS AGREEMENT.
(1) Insert X if wages paid are overscale.
Include all music prep. information on this form or a continuation sheet, with copies of invoices attached.
FOR FUND USE ONLY:
FORM B-6/Rev. 9-96
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