Musicians' Association Local 65-699
P.O. Box 8748
Houston, Texas 77249
December 5, 2020
APPLICATION FOR MEMBERSHIP IN THE UNITED STATES
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District Of Columbia
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Must agree to terms
I agree to terms
I pledge to abide by all Rules, Regulations, and Bylaws of the AFM and the Local stated above. I agree to pay all
dues and assessments (including work dues on all musical services performed) required by those Bylaws. I
further agree to complete any orientation or indoctrination required by that Local within the time specified by its
Bylaws. I authorize the American Federation of Musicians and the above-named Local to act as my collective
bargaining representative with full power to execute collective bargaining agreements with employers governing
terms and conditions of employment.
I further authorize the AFM, in the name of the AFM or in my name, to do all acts, initiate all proceedings,
execute, acknowledge and deliver any and all documents and pleadings, litigate, collect and receive money, and,
in the AFMâ€™s sole judgment, join me as a party plaintiff or defendant in suits or proceedings, or to bring suit in
my name or the AFMâ€™s name, in respect of any AFM collectively negotiated agreement or any statutory royalty or
remuneration payment to which I may be entitled under the laws of the United States or other countries or under
international law or treaties. I authorize the AFM to offset from any royalties and remunerations collected the
reasonable expenses of collecting, administering and distributing those royalties and remunerations.
I also understand that, when the Federation receives any residual payments for a new use of a musical product,
the Federation will deposit those monies into a separate interest-bearing account and then will attempt to identify
and locate the musicians to whom the payments are due and to distribute those payments to them. In the event
that I cannot be identified and located, and I do not file a claim for payment with the Federation within three
years after the Federation receives the payment, I authorize the Federation thereafter to transfer the monies due
to me to the general treasury to be used to defray the costs of administering and operating the Federation;
provided, however, that at any subsequent point I may file a written claim with the Federation and, upon doing
so, I shall be entitled to receive the residual payment to which I am entitled (without interest and offset by the
applicable Federation work dues) unless the State is then holding the residual payment I am due, in which case I
shall apply to the State for my payment.
Work Dues Check-Off Authorization (U.S.)
I hereby voluntarily authorize and direct any party who engages my musical services to deduct from my
compensation for those services the uniformly required dues or fees based on earnings, including work dues
and/or agency or service fees, as set forth in the Bylaws of the American Federation of Musicians of the United
States and Canada (Federation Work Dues) and/or the dues or fees based on earnings including work dues
and/or agency fees, as set forth in the Constitution and/or Bylaws of the Local Union hereof having jurisdiction
over these services (Local Union Work Dues). I further authorize, and direct, each such party who engages my
musical services to remit promptly all Work Dues thus deducted to the Federation or the appropriate Local Union
thereof in accordance with the applicable regulations, and at the times specified in those regulations. Where the
payment of either dues or agency or service fees is lawfully required as a condition of employment, said
deductions shall be made irrespective of my membership in the Federation and/or the Local Union thereof. This
authorization shall be irrevocable for a period of one (1) year from the date hereof or, with respect to any
employer having a collective bargaining agreement, until the termination date of the current collective bargaining
agreement, whichever occurs sooner. This authorization shall automatically renew itself and be irrevocable for
successive annual periods unless I give written notice to the Federation and those Local Unions of which I am a
member within the fifteen (15) day period following the expiration of any such annual period or, with respect to
any employer having a collective bargaining agreement, within the fifteen (15) day period following the
termination date of any such collective bargaining agreement.
Note: Dues, contributions or gifts to the American Federation of Musicians are not tax deductible as charitable
contributions. However, they may be tax deductible as ordinary and necessary business expenses.
Local Officer Approval __________________________________________________Date _____________________
AFM app.pdf 2
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