AFTRA TALENT CHECK AUTHORIZATION FORM

SAG-AFTRA RESIDUALS CHECK AUTHORIZATION FORM (MINORS)
You are hereby authorized and directed to send Artist’s residual checks for the production or markets listed below to the following
franchised talent agent:
Agency Name:
_______________________________________
Agency ID #:
_______________________________________
_________________________________
DATE
___________________________________________
SIGNATURE OF PARENT/GUARDIAN
_________________________________
SOCIAL SECURITY NUMBER
___________________________________________
ARTIST'S NAME (Printed or Typed)
_________________________________
LOAN OUT COMPANY NAME
___________________________________________
FEDERAL ID#
ENCLOSE COPY OF BIRTH CERTIFICATE, COURT ORDER, OR OTHER EVIDENCE THAT THE PERSON EXECUTING THIS FORM IS
THE PARENT/GUARDIAN OF ARTIST. In lieu of such evidence, a duly authorized representative of the Agency must execute the following:
The undersigned Agency hereby agrees to defend, indemnify, and hold Screen Actors Guild-American Federation of Television and Radio Artists
harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or in connection with compliance with
this residuals check authorization.
_________________________________
________________________________
Signature of Representative
Agency Name
Initial below: Complete either Section A or Section B. If both are selected, SAG-AFTRA will default to Section B.
__________________________________________________________________________________________________
SECTION A: All Commissionable Residuals Check Authorization
NETWORK PRIMETIME/ Exhibit A/ CW (All Commissionable Checks)
NON-NETWORK (SYNDICATION)/ NON-PRIMETIME FREE TV (All Commissionable Checks)
For Section A Only: This Authorization SUPERSEDES ANY PRIOR DATED AUTHORIZATION that SAG-AFTRA may have on file for
me with this agency or any other agency.
______________________________________________________________________________________________________
SECTION B: Episodic Check Authorization Only (Network Primetime/ Exhibit A/ CW, Non-Network (Syndication)/ Non-Primetime Free TV)
Production Company: ____________________________________________________
Production Series/Title: _________________________________________________
Production Episode # and Title: ____________________________________________
Please deliver to either office:
Los Angeles
SAG-AFTRA: Professional Representatives Dept., 5757 Wilshire Bl.,
7th Fl., Los Angeles, CA 90036
New York
SAG-AFTRA: Professional Representatives Dept., 1900 Broadway, 5th
Floor, New York, NY 10023
This authorization will remain in effect until WRITTEN notice of revocation is made by actor or his/her parent or guardian. I hereby agree to
indemnify and hold SAG-AFTRA harmless of and from any and all loss, cost or expense which may be incurred or suffered by SAG-AFTRA, by reason
of any action taken by SAG-AFTRA, in reliance upon this authorization. SAG-AFTRA will accept ORIGINAL signatures only, no photocopies. This
authorization covers all work within SAG-AFTRA’s jurisdiction. Please retain copies for your records.