(Category C)
SAG members who have:
1. been represented by an agent at any time within the last five (5) years from the date SAG announces a referendum on a proposed Agency Agreement and
2. paid at least two thousand ($2000) dollars in commissions to an agent within such five (5) years. Documentation: Affidavit filed with S.A.G. 30 days prior to mail date of referendum.
Qualified Voting Affidavit
I, _____________________________, (please print clearly) am a current member of the Screen Actors Guild ("SAG"). My SAG member ID number is___________________ (please print clearly).
Check One: I am currently being represented by the following agency
_________________________________ (please print clearly) under an oral representation agreement.
I hereby attest to the following: I have been represented by one or more agents in connection with employment under S.A.G.'s jurisdiction within the last five (5) years from the date of execution of this document, and I have paid at least two thousand ($2000) dollars in commissions to such agent(s) in connection with such representation.
I, the undersigned, declare, under penalty of perjury of the laws of the
state of __________________________ (insert state where signed), that the above-stated facts are true and correct.
SAG Performer Signature
Date
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