Forms

Accident Report Form

ACH Withdrawal. If you'd like Local 728 to automatically withdraw your quarterly dues amount from your checking account every quarter, fill out this form.
You will receive an email reminder notice a few days before the withdrawal is made, so that you can make any account adjustments necessary.

Group life insurance beneficiary form - Local 728 has one of the most generous group life insurance benefit plans in the IATSE. When you filled out your application to join the Local, you filled out a beneficiary form. Sometimes this information needs to be updated. If you are unsure of who you designated to be your beneficiary upon your passing, or are certain that the information you put on file at the time of your application needs to be changed, please call the Local for this form. (818) 954-0728.

Change of Address. We are required to have an accurate mailing address for every member. If you change your mailing and/or residence address, please let us know by filling out this form.

Honorable Withdrawal. If you will no longer be seeking employment as a Local 728 industry employee, but may do so at a future time, taking an honorable withdrawal will stop the quarterly billing process on your account.

I-9 - Department of Homeland Security Employment Eligibility Verification. Your I-9 form must be up to date with CSATF in order to be employed. You can download the form here and have it notarized at the Local. Please call to make an appointment with our notary. 

Lost Membership Card. You must carry a Local 728 union card with the current quarter's stamp on your person when working on a union production and why wouldn't you just as a matter of pride? If you've lost or misplaced your card, fill out this form and return it to the Local's office to get a replacement.

Retiree Status Form. You had to fill out an application form to become an active member of Local 728, upon your retirement, we ask that you inform us of which retirement status you wish to have by filling out this form. 

Sick Dues. If you are ill or disabled due injury and cannot pay a quarter's dues, fill out the application for sick dues payment or reimbursement.  

MPTV Fund Payroll Deduction Form. The Motion Picture Television Fund's motto is "we take care of our own". Entirely funded on charitable contributions, this fund is here for us and our families with a large pallet of assistance programs. Every small donation whether one-time or regular helps MPTF help our brothers and sisters who are in need.

W-4 - 2019. IRS Federal Tax Withholding form.

Entertainment Industry Foundation. If your cup runneth over, let some spill out! 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: www.eifoundation.org

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.

Physician Form (Predesignation of Personal Physician) - Use this form to notify your employer if you wish to have your personal medical doctor or a doctor of osteopathic medicine treat you for a work-related injury or illness. See form for conditional requirements.

CLT Form - Click here to download the 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, please fill out the following form.

Address

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

Conditions of Use | Site Map

Phone

Office:
  818-954-0728
  800-551-2158
FAX:
  818-954-0732

Local 728 Bulletin

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