Accident Report Form

Change of Address

Lost Membership Card

Honorable Withdrawal

Retiree Status

ACH Withdrawal

Sick Dues

MPTVFund Payroll Deduction Form
If your cup runneth over, let some spill out! Donate to the Entertainment Industry Foundation. You can help the Foundation help others who are less fortunate. It’s easy, you can even make an automatic payroll deduction, it’s painless. Check out their web site at:

728 Beneficiary Form - Please call the Local for this form.
(818) 954-0728

Physician Form - used to inform your employer of your personal physician's contact information in case of emergency

CLT Form - Click here to download the request form you need to fill out in order to be placed on the CLT list

Distant Location Form - Attention ACLT's: If you are going on a distant location, here’s some information you need to know concerning your responsibility as an ACLT

MPI Plans Participation & IAP Percent Contribution Form
("The Home Plan") (when on distant location) Rev. 022813
On February 28, 2013, the Board of Directors approved an amendment to the MPI as Home Plan Resolution and Election Form. The revised Resolution now requires an additional signature from the IATSE on the election form. (attached)
As a reminder, the Resolution also requires the Employer to provide a copy of the applicable collective bargaining agreement the employee is performing covered work under.
Please be aware the use of this new form is effective immediately.

I-9 - Department of Homeland Security Employment Eligibility Verification

2012 W-4 - IRS Form W-4 to determine your Federal Tax Withholding amount


IATSE, Local 728
Studio Electrical Lighting Technicians
1001 W. Magnolia Blvd.
Burbank, CA 91506
(818) 954-0728

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Local 728 Bulletin

The color version of the Local 728 Bulletin is available online.