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Signatory Application 09.27.16 1
SIGNATORY APPLICATION
Directors Guild of America, Inc.
7920 Sunset Boulevard
Los Angeles, CA 90046
Phone: (310) 289-5316
Email: Signatories@dga.org
1. This signed Signatory Application, along with the items indicated below, must be
submitted to the Guild at least 4 weeks before principal photography starts:
Signatory Application - please complete top of page 2, then go to the appropriate
project type:
Page 2 – Theatrical
Page 3 – Television
Page 4 – New Media
Signatory Company Formation Documents
All Parent Company Formation Documents
2. A Signatories Representative will contact you to confirm whether the entity is the
appropriate Signatory Company. If so, the Representative will require the following:
Letter of Adherence
Deal Memos
Low Budget Sideletter Agreement (if applicable)
Budget (for low budget features)
3. After review of the above documentation, the Signatory Company may be required to
deliver the following:
Payroll deposits
Chain of title (including distribution, production services and sales agency agreements)
Guaranty
Security Agreement
Residuals coverage (e.g., residuals reserve, Distributor’s Assumption Agreements)
Financing agreements
PLEASE NOTE: DGA members may not be permitted to begin rendering services
during principal photography until all required financial assurances are delivered.
In addition, some financial assurances may be required before DGA members are
permitted to travel outside of the United States or Canada.
Signatory Application 07.08.16 2
PROJECT INFORMATION FORM
COMPLETE THIS SECTION FOR ALL PROJECTS:
LOCATIONS
PRODUCTION DATES
Pre-Production:
Pre-Production Start:
Principal Photography:
Principal Photography Start:
Principal Photography Wrap:
Post Production:
Post Production Wrap:
Is this project SAG-AFTRA-covered? □ Yes □ No
Is this project WGA-covered? □ Yes □ No
Writer(s):
THEATRICAL
PROJECT TITLE (include AKAs)
Check One: □ Feature Film
□ Low Budget Feature
□ Documentary Feature
□ Short Film
□ Experimental (< 30 min and ≤ $50K and not made for public exhibition)
Total Gross Budget (US$)
Format: □ Film □ Digital □ Other
Running Time (in minutes)
(See pages 3 and 4 for other project types; skip to page 5 if this section is complete)
Signatory Application 09.27.16 3
PROJECT INFORMATION FORM
TELEVISION
PROJECT TITLE (include AKAs)
Series: □ Episodic Series □ Mini Series □ Documentary Series
□ Limited Series
Pilot? □ Yes □ No
Number of Episodes:
Episode Total Gross Budget: (US$):
Episode Length (in minutes):
OR:
Single Project: □ Motion Picture (e.g. Movie of the Week) □ Documentary
□ Special □ Presentation
Total Gross Budget (US$):
Running Time (in minutes):
Format: □ Film □ Digital □ Other
Made for: □ Prime Time □ Non-Prime Time
Genre:
□ Dramatic
□ Comedy
□ Variety
□ News
□ Sports
□ Reality □ Documentary
□ Talk
□ Quiz & Game
□ Other (specify):
Pay Television
Basic Cable
□ Cinemax
□ HBO
□ Showtime
□ Starz
□ TMC
□ Other (specify):
□ Direct-to-video
□ A&E □ Nat Geo
□ AMC □ Nickelodeon
□ Discovery □ MTV
□ Freeform □ TBS
□ F/X □ TNT
□ Hallmark □ TV Land
□ Lifetime □ USA
□ Other (specify):
(See pages 2 and 4 for other project types; skip to page 5 if this section is complete)
Signatory Application 09.27.16 4
PROJECT INFORMATION FORM
MADE FOR NEW MEDIA
□ Original
□ Derivative, based on
PROJECT TITLE (include AKAs)
Series: □ Episodic Series □ Mini Series □ Documentary Series
□ Limited Series
Pilot? □ Yes □ No
Number of Episodes:
Episode Total Gross Budget: (US$):
Episode Length (in minutes):
OR:
Single Project: □ Motion Picture □ Documentary □ Special
Total Budget (USD):
Running Time (in minutes):
Format: □ Film □ Digital □ Virtual Reality (VR) □ Other (specify):
Genre:
□ Dramatic
□ Comedy
□ Variety
□ News
□ Sports
□ Reality □ Documentary
□ Talk
□ Quiz & Game
□ Other (specify):
Exhibition:
Name of platform:
□ Subscription Video on Demand
(Netflix, Hulu, Amazon Prime, etc.)
□ Transactional Video on Demand
(iTunes, Vimeo, etc.)
□ Free-to-the-consumer/advertiser-supported
(Crackle, Hulu, etc.)
□ Self-distribution
□ Other (specify website, service or carrier):
Distribution:
Has the project been licensed in other markets
(theatrical, basic cable, pay TV, free TV)?
□ Yes □ No
If Yes, list all licensors below and complete information
on Page 12:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
If any brand or advertising agency is involved,
fill out the below:
Product/Brand:
Agency:
Other: □ Interactive
□ Promo Trailer
□ Educational
□ Other (Specify):
(See pages 2 and 3 for other project types; skip to page 5 if this section is complete)
Signatory Application 06.27.17 5A
PROJECT STAFFING
STAFFING WAIVERS: All staffing waivers must be approved in writing prior to principal photography by
the appropriate DGA executive. Please submit a signed deal memo for each position listed below.
Theatrical/MOW/Single Camera or New Media:
Position and Name (print full name)
DGA
Member?
If NO, provide contact
information:
Start Date
Director:
□ Yes □ No
Phone:
Email:
UPM:
□ Yes □ No
Phone:
Email:
1AD:
□ Yes □ No
Phone:
Email:
Key 2AD:
□ Yes □ No
Phone:
Email:
Second 2AD:
□ Yes □ No
Phone:
Email:
Additional 2AD:
□ Yes □ No
Phone:
Email:
Second Unit Director:
□ Yes □ No
Phone:
Email:
Other:
□ Yes □ No
Phone:
Email:
Multi-Camera/Prime-Time Dramatic or New Media:
Position and Name (print full name)
DGA
Member?
If NO, provide contact
information:
Start Date
Director:
□ Yes □ No
Phone:
Email:
UPM:
□ Yes □ No
Phone:
Email:
1AD:
□ Yes □ No
Phone:
Email:
Key 2AD:
□ Yes □ No
Phone:
Email:
Second 2AD:
□ Yes □ No
Phone:
Email:
Additional 2AD:
□ Yes □ No
Phone:
Email:
Associate Director:
□ Yes □ No
Phone:
Email:
Associate Director (line cut):
□ Yes □ No
Phone:
Email:
Other:
□ Yes □ No
Phone:
Email:
Signatory Application 06.27.17 5B
PROJECT STAFFING
STAFFING WAIVERS: All staffing waivers must be approved in writing prior to principal photography by
the appropriate DGA executive. Please submit a signed deal memo for each position listed below.
Live & Tape (Multi-Camera, other than Prime-Time Dramatic) or New Media:
Position and Name (print full name)
DGA
Member?
If NO, provide contact
information:
Start Date
Director:
□ Yes □ No
Phone:
Email:
Associate Director:
□ Yes □ No
Phone:
Email:
Stage Manager:
□ Yes □ No
Phone:
Email:
2nd Stage Mgr:
□ Yes □ No
Phone:
Email:
3rd Stage Mgr:
□ Yes □ No
Phone:
Email:
Production Associate/Assistant:
□ Yes □ No
Phone:
Email:
Other:
□ Yes □ No
Phone:
Email:
Signatory Application 07.08.16 6
SIGNATORY COMPANY INFORMATION
Company Name:
The Guild does not accept loan-out corporations or DBAs as signatory
companies. The DGA-Producer Pension and Health Plans does not
accept contributions from loan-out corporations, DBAs or sole
proprietorships.
□ DGA Member-owned?
Form of Organization:
□ corporation (Inc.)
□ limited liability company (LLC)
□ limited partnership (LP)
□ other (specify):
Please provide the required items listed below:
□ Articles of Incorporation; Certificate of Formation; or other document of organization
□ Certified Bylaws; Operating Agreement; other document evidencing ownership/governance
State/Country/Jurisdiction of Organization:
Date of Organization/Registration:
Organizational ID: Federal Tax ID:
Address:
City: State/Country: Zip/Postal Code:
Primary Contact:
Telephone: Email:
Shareholders; Members; Owners: □ complete page 7 for each company listed below
Name (individual/company)
Percentage of
Ownership
Officers; Managers; Principals: □ complete page 7 for each company listed below
Name (individual/company)
Title/Position
Production History:
Is any above-named individual involved in any other production company? □ Yes □ No
Name
Production Company
DGA
Signatory?
□ Yes □ No
□ Yes □ No
□ Yes □ No
□ Yes □ No
Signatory Application 07.08.16 7
PARENT COMPANY INFORMATION
Parent Company:
□ DGA Member-owned?
Form of Organization:
□ corporation (Inc.)
□ limited liability company (LLC)
□ limited partnership (LP)
□ other (specify):
Please provide the required items listed below:
□ Articles of Incorporation; Certificate of Formation; or other document of organization
□ Certified Bylaws; Operating Agreement; other document evidencing ownership/governance
State/Country/Jurisdiction of Organization:
Date of Organization/Registration:
Organizational ID: Federal Tax ID:
Address:
City: State/Country: Zip/Postal Code:
Primary Contact:
Telephone: Email:
Shareholders; Members; Owners: □ complete page 7 for each company listed below
Name (individual/company)
Percentage of
Ownership
Officers; Managers; Principals: □ complete page 7 for each company listed below
Name (individual/company)
Title/Position
Production History:
Is any above-named individual involved in any other production company? □ Yes □ No
Name
Production Company
DGA
Signatory?
□ Yes □ No
□ Yes □ No
□ Yes □ No
□ Yes □ No
Please attach additional pages as needed.
Signatory Application 07.08.16 8
ULTIMATE PARENT COMPANY INFORMATION
Ultimate Parent:
□ DGA Member-owned?
Form of Organization:
□ corporation (Inc.)
□ limited liability company (LLC)
□ limited partnership (LP)
□ other (specify):
Please provide the required items listed below:
□ Articles of Incorporation; Certificate of Formation; or other document of organization
□ Certified Bylaws; Operating Agreement; other document evidencing ownership/governance
State/Country/Jurisdiction of Organization:
Date of Organization/Registration:
Organizational ID: Federal Tax ID:
Address:
City: State/Country: Zip/Postal Code:
Primary Contact:
Telephone: Email:
Shareholders; Members; Owners: □ complete page 7 for each company listed below
Name (individual/company)
Percentage of
Ownership
Officers; Managers; Principals: □ complete page 7 for each company listed below
Name (individual/company)
Title/Position
Production History:
Is any above-named individual involved in any other production company? □ Yes □ No
Name
Production Company
DGA
Signatory?
□ Yes □ No
□ Yes □ No
□ Yes □ No
□ Yes □ No
Please attach additional pages as needed.
Signatory Application 07.08.16 9
FINANCING INFORMATION
How will the project be financed? □ Debt □ Equity □ Combination
□ Other (specify):
LENDER: Percentage of Budget %
(check all □ Production loan □ Single picture loan Loan Amount
that apply) □ Gap financing □ Revolving credit facility □ attach copy of loan agreement
□ Tax credits □ Other (specify):
Has the loan closed? □ Yes □ No If Yes, provide the date of closing:
Does the lender have a lien or security interest? □ Yes □ No Lien filing date:
Attorney/Contact:
Email: Phone:
Borrower(s) (if different from Signatory Company):
LENDER: Percentage of Budget %
(check all □ Production loan □ Single picture loan Loan Amount
that apply) □ Gap financing □ Revolving credit facility □ attach copy of loan agreement
□ Tax credits □ Other (specify):
Has the loan closed? □ Yes □ No If Yes, provide the date of closing:
Does the lender have a lien or security interest? □ Yes □ No Lien filing date:
Attorney/Contact:
Email: Phone:
Borrower(s) (if different from Signatory Company):
FINANCIER: Percentage of Budget %
□ Equity Financing Amount
□ Distribution Advance/Licensing Fee □ attach copy of financing agreement
□ Personal Funds
Does the financier have a lien or security interest? □ Yes □ No Lien filing date:
Attorney/Contact:
Email: Phone:
FINANCIER: Percentage of Budget %
□ Equity Financing Amount
□ Distribution Advance/Licensing Fee □ attach copy of financing agreement
□ Personal Funds
Does the financier have a lien or security interest? □ Yes □ No Lien filing date:
Attorney/Contact:
Email: Phone:
Please attach additional pages as needed.
Signatory Application 07.08.16 10
PARTICIPATIONS
1. Is any party receiving payment from first dollar gross receipts? □ Yes □ No
2. Will any party be repaid before residuals are paid? □ Yes □ No
Complete the below for any party receiving payments from first dollar gross receipts:
Name_____________________________________________ □ attach copy of underlying agreement
□ Gross Participant □ Financier □ Sales Agent □ Distributor
How much (or what percentage) will be paid?
Attorney/Contact:
Email: Phone:
Name_____________________________________________ □ attach copy of underlying agreement
□ Gross Participant □ Financier □ Sales Agent □ Distributor
How much (or what percentage) will be paid?
Attorney/Contact:
Email: Phone:
Name_____________________________________________ □ attach copy of underlying agreement
□ Gross Participant □ Financier □ Sales Agent □ Distributor
How much (or what percentage) will be paid?
Attorney/Contact:
Email: Phone:
COLLECTION ACCOUNT MANAGEMENT AGREEMENT
Will there be a CAMA? □ Yes □ No If Yes, complete the below:
CAMA Territory: □ worldwide □ foreign □ domestic □ other (specify):
Will any party be paid before the CAMA becomes effective? □ Yes □ No
If Yes, identify such parties:
Signatory Application 07.08.16 11
COPYRIGHT
□ Please provide a copy of complete Chain-of-Title, including documents not recorded with U.S.
Copyright Office.
Who currently owns copyright?
Who will own copyright after the project is completed?
Who currently has any rights in the projects, including via transfer, assignment or license?
Identify any parties will a security interest in the rights:
Is the screenplay or teleplay registered with U.S. Copyright Office? □ Yes □ No
If Yes, provide the registration date:
Who is/will be the Copyright Claimant on the Form PA?
SALES AGENT
□ Sales Agent (specify):
Territory: □ worldwide □ foreign □ domestic □ other (specify):
Term: Media/Rights:
Contact: Email: Phone:
□ Sales Agent (specify):
Territory: □ worldwide □ foreign □ domestic □ other (specify):
Term: Media/Rights:
Contact: Email: Phone:
□ Sales Agent (specify):
Territory: □ worldwide □ foreign □ domestic □ other (specify):
Term: Media/Rights:
Contact: Email: Phone:
Please attach additional pages as needed.
Signatory Application 07.08.16 12
LICENSING AND DISTRIBUTION
The Guild may require a residuals reserve. In that case, a Signatories Representative will inform the
Employer of the reserve amount. The reserve will be drawn upon to pay residuals as they become due and
payable.
Will Distributor be delivering an executed Assumption Agreement or QD/QRP letter for all licensed
rights? CHECK ALL THAT APPLY:
□ Letter of Guaranty from QD/QRP company (specify):
Territory: □ worldwide □ foreign □ domestic □ other (specify):
Term: Media/Rights:
Contact: Email: Phone:
□ QD □ QRP
□ Letter of Guaranty from QD/QRP company (specify):
Territory: □ worldwide □ foreign □ domestic □ other (specify):
Term: Media/Rights:
Contact: Email: Phone:
□ QD □ QRP
□ Assumption Agreement from Distributor/Buyer (specify):
Territory: □ worldwide □ foreign □ domestic □ other (specify):
Term: Media/Rights:
Contact: Email: Phone:
□ Assumption Agreement from Distributor/Buyer (specify):
Territory: □ worldwide □ foreign □ domestic □ other (specify):
Term: Media/Rights:
Contact: Email: Phone:
Please attach additional pages as needed.
Signatory Application 07.08.16 13
CONTACT INFORMATION
SIGNATORY COMPANY:
Primary Contact: Title:
Address: City/State/Zip:
Email: Phone:
Production Office (if different from above): □ temporary □ permanent
Primary Contact: Title:
Address: City/State/Zip:
Email: Phone:
Accountant:
Contact:
Address: City/State/Zip:
Email: Phone:
Post Production Supervisor:
Contact:
Address: City/State/Zip:
Email: Phone:
Post Production Accountant:
Company:
Contact:
Address: City/State/Zip:
Email: Phone:
Production Attorney:
Name: Law Firm:
Address: City/State/Zip:
Email: Phone:
Agent for Service of Process:
Name: Law Firm:
Address: City/State/Zip:
Email: Phone:
Reports Compliance Contact (Deal Memos, Weekly Work Lists, Quarterly Earnings and Employment Data Reports):
Name: Title: Company:
Email: Phone:
Screen Credits Contact:
Name: Title: Company:
Email: Phone:
Residuals Contact:
Name: Title: Company:
Email: Phone:
Signatory Application 07.08.16 14
PAYROLL DEPOSITS
The Signatories Representative will calculate and inform the Employer of the amounts required
to fund drawdowns and deposits for compensation and benefit plan contributions.
The drawdown and deposit agreements must be signed, and the funds must be delivered to
the payroll house no later than 5 business days prior to the commencement of principal
photography.
Payroll House: Contact:
Phone: Email:
RESIDUALS RESERVE
The Guild may require a residuals reserve. The Signatories Representative will inform the Employer
whether a Residuals Reserve is required and the amount, if applicable. The reserve will be drawn upon to
pay residuals as they become due and payable.
BOND COMPANY
Bond Company:
Address:
City: State/Country: Zip/Postal Code:
Attorney/Contact:
Email: Phone:
Bonded entity/ies:
Was the bond issued? □ Yes □ No If Yes, provide bond closing date:
Does the bond company have a security interest? □ Yes □ No If Yes, provide filing date:
CERTIFICATION BY AUTHORIZED REPRESENTATIVE
The undersigned, by signing below, certifies, represents and warrants that: (a) s/he has the
requisite power and authority to sign this document on behalf of the Signatory Company; (b) s/he
reviewed the foregoing information; and (c) such information is complete, true and accurate to
the best of her/his knowledge. Further, the undersigned acknowledges and agrees any omission,
misrepresentation or false statement of fact knowingly made herein and material to the financial
assurances delivered by the Signatory Company to the Guild will constitute a default under the
Security Agreement applicable to this project. A scanned or electronic signature has the same
force and effect as an original signature.
Signatory Company:
By: Date:
(Signature)
Print Name: Title:
Directors Guild of America
7920 Sunset Blvd.
Los Angeles, CA 90046
(310) 289-2000
RCForms@dga.org
MADE FOR NEW MEDIA
DIRECTOR DEAL MEMORANDUM
This confirms our agreement to employ you to direct the covered made-for-New Media project described as follows
(and as referenced in Sideletter No. 35 of the BA and Sideletter No. 28 of the FLTTA):
DIRECTOR INFORMATION:
Name: ___________________________________________________________________________ SSN# (last 4 digits): _____________
Loanout: _________________________________________________________________________ FID. #: _________________________
Address: ___________________________________________________________________________________________________________
Phone #: _________________________________ Email: ______________________________________________________________________
Your SALARY shall be $__________________
per project
per episode
per week
per day
Guaranteed Period of Employment (if any): ______________________________________________________________________________
Start Date (on or about): ______________________________________________________________________________________________
Other Conditions (including credit above the minimum): ___________________________________________________________________
_____________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
ACCEPTED AND AGREED:
The Employee hereby authorizes the Employer to deduct from his or her salary the amount specified in the Directors Guild
of America Basic Agreement and/or Freelance Live and Tape Television Agreement as the Employee’s contribution to the
Directors Guild of America–Producer Pension Plan. The Employer will pay the amount so deducted directly to the Pension
Plan on the Employee’s behalf.
Signatory Employer (Company Name): _________________________________________________________________________
Signatory Employer Representative Signature: ___________________________________________________________________
Date: ________________________________________________________
Employee Signature: ___________________________________________________________________
Date: ________________________________________________________
PROJECT INFORMATION:
Current Title of Project: _______________________________________________________________________________________________
Episodic Series — Title of Episodes Directed: ________________________________________________________________________
_______________________________________________________________________________________________________________
Single Project — Total run time (minutes) (approximately, if known): _______________________
Project Type:
Dramatic
Variety
Quiz/Game Show
"All Other"
Other (specify) __________________________
NewMed - DM-DIR
Directors Guild of America
7920 Sunset Blvd.
Los Angeles, CA 90046
(310) 289-2000
RCForms@dga.org
MADE FOR NEW MEDIA
UNIT PRODUCTION MANAGER, ASSISTANT DIRECTOR,
ASSOCIATE DIRECTOR, STAGE MANAGER
DEAL MEMORANDUM
This confirms our agreement to employ you on the covered made-for-New Media project described as follows
(and as referenced in Sideletter No. 35 of the BA and Sideletter No. 28 of the FLTTA):
AD/UPM or AD/SM INFORMATION:
Name: ___________________________________________________________________________ SSN# (last 4 digits): _____________
Loanout: _________________________________________________________________________ FID. #: _________________________
Address: ___________________________________________________________________________________________________________
Phone #: _________________________________ Email: ______________________________________________________________________
Position:
Your STARTING DATE for such employment shall be: __________________________
Your SALARY shall be $__________________
per project
per episode
per week
per day
per hour
Other Conditions: ___________________________________________________________________________________________________
___________________________________________________________________________________________________________________
PROJECT INFORMATION:
Current Title of Project: _______________________________________________________________________________________________
Episodic Series – Number of Episodes (if known): _________ Run Time per Episode (approximately, if known): _________________
Single Project – Total run time (minutes) (approximately, if known): _______________
ACCEPTED AND AGREED:
The Employee hereby authorizes the Employer to deduct from his or her salary the amount specified in the Directors Guild
of America Basic Agreement and/or Freelance Live and Tape Television Agreement as the Employee’s contribution to the
Directors Guild of America–Producer Pension Plan. The Employer will pay the amount so deducted directly to the Pension
Plan on the Employee’s behalf.
Signatory Employer (Company Name): _________________________________________________________________________
Signatory Employer Representative Signature: ___________________________________________________________________
Date: ________________________________________________________
Employee Signature: ___________________________________________________________________
Date: ________________________________________________________
(BA-Covered Categories)
Unit Production Manager
First Assistant Director
Key Second Assistant Director
Second Second Assistant Director
Additional Second Assistant Director
(FLTTA-Covered Categories)
Associate Director
Stage Manager
NewMed - DM-BTL
DIRECTORS GUILD OF AMERICA, INC.
REPORTS COMPLIANCE
Deal memoranda and the reports described below must be submitted to:
rcforms@dga.org
Phone: 310-289-2064
DEAL MEMORANDA (“DM”) [BA Paragraphs 4-108 and 13-107]
Fully-executed and complete deal memos are due at the Guild prior to the commencement of employment of every
DGA-covered employee. Please make sure all required fields on the deal memo are complete, and that the DGA
member and an authorized representative of the signatory company sign the form before submitting to the Guild.
Incomplete or incorrect deal memos will be returned to production for correction.
EMPLOYMENT DATA REPORT (“EDR”) [BA Art. 15 and FLTTA Art 19]
Employers are required to submit only one report after the project wraps, taking into account all members
employed on the project during principal photography. The EDR should not include DGA Trainees. If an Employer
is unable to submit the EDR within the required time period, it may request an additional 15 days within which to
submit the report, which request the Guild will not unreasonably deny. (See enclosed instructions for additional
submission requirements.)
EMPLOYER QUARTERLY GROSS EARNINGS REPORT (“GER”) [BA 1-501 and FLTTA Art. 5]
Within 15 days of the close of each calendar quarter, the company must submit a list of all persons employed in
DGA-covered categories and their total gross earnings for that quarter. Please provide the last 4 digits of the SSN
for each individual listed, and the name of the project. Each report must cover only one signatory company but
may include multiple projects by that company.
Gross earnings include, but are not limited to:
*
salary (prep, shoot & post)
* production fee
* completion of assignment
*
extended workday/overtime
* turnaround pay
* holiday pay (worked & unworked)
*
vacation pay
* series sales bonus
* capricious discharge pay
Gross earnings should not include residuals payments of any kind, per diem (including incidentals), travel allowance,
profit participation, gross participation and reimbursements which are not compensation for services rendered
under the BA or FLTTA. If the company uses a payroll company (e.g., Entertainment Partners, Cast and Crew, etc.)
to pay employees, the payroll company may submit a GER to the Guild. Be sure to confirm with the payroll company
prior to submission to avoid duplication.
WEEKLY WORK LIST (“WWL”) [BA 1501]
The company must submit a Weekly Work List to the Guild listing all members’ categories and dates of employment
for their work on the project the previous week. Be sure to list only individuals employed in DGA-covered categories
and exclude anyone working in a non-covered position (e.g., DGA Trainee or Producer).
Note: Category distinctions are important, to avoid confusion, please use the following abbreviations: Unit
Production Manager = UPM, First Assistant Director = 1AD, Key Second Assistant Director = 2AD, Second 2nd
Assistant Director = 2nd 2AD, Additional Second Assistant Director = Add'l 2AD.
Deal memoranda and other Reports Compliance forms can be found on the DGA website at www.dga.org.
(At the top of the homepage, place the cursor on "Employers," select "Deal Memos & Reports Compliance Forms.")
White
African- American
Hispanic
Asian-American
Native American
Unknown
MALE
1/56
FEMALE
1/25
Instructions for Employment Data Report
Pursuant to Article 15 of the DGA Basic Agreement and Article 19 of the DGA Freelance Live & Tape
Television Agreement, Employers must submit a report identifying the gender and ethnicity of
persons employed in DGA-covered categories. The report must also identify Directors employed
on prime-time dramatic television programs who have no prior credits on prime time dramatic
television programs. Please use the section labeled “First Time Directors” if applicable.
The Employment Data Report must be submitted:
- once for a theatrical motion picture, television motion picture ninety (90) minutes or
longer, pilot, presentation or single program and is due within 45 days after close of
principal photography;
- once per season for an episodic television series and is due within 45 days after the wrap
or recording of the last episode; or
- once per year for strip dramatic, strip variety, quiz and game and “All Other” programs
produced on an annual rather than seasonal basis and is due no later than February 15th
of each year following production.
Two types of statistics must be reported in the following format:
1. Indicate the number of persons employed in the categories listed below:
White Asian-American
African-American Native American
Hispanic Unknown
2 Indicate the total number of days worked or guaranteed. Total days should
include travel days, prep days, production days and post-production days.
When the same member is employed on multiple episodes in a series, the
employee should only be counted once in the number of employees, but all
the employee's cumulative days worked should be included in the total
number of days worked or guaranteed.
* * * *
The below example shows one male White director was employed for a total of 56 days worked or
guaranteed. One female African American director was employed for a total of 25 days worked or
guaranteed.
DIRECTOR:
Date:
Signatory Company:
Project Title:
Prepared By:
Season/Year Covered:
Phone:
Email:
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
Return To: rcforms@dga.org
Phone: 310-289-2064
DGA Employment Data Report
(print or type)
DIRECTOR:
FIRST TIME DIRECTORS: Primetime Dramatic Television Programs
UNIT PRODUCTION MANAGER:
FIRST ASSISTANT DIRECTOR:
SECOND ASSISTANT DIRECTOR (all SecondADs, including Key Second ADs, Second Second ADs and Additional Second ADs):
ASSOCIATE DIRECTOR (formerly known as “Technical Coordinators”): Primetime Multi-CameraDramatic Programs
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
ASSOCIATE DIRECTOR: Live & Tape Television
White
African-American
Hispanic
Asian-American
Native American
Unknown
MALE
FEMALE
STAGE MANAGER: Live & Tape Television
Directors Guild of America
Employer Quarterly Gross Earnings Report
QUARTER/YEAR COVERED:
Signatory Company:
ContactName:
Address:
City/State/Zip:
Phone: Email:
RETURN TO:
rcforms@dga.org
PPhone
Phone: 310-289-2064
Name
SSN (last 4 digits)
Category
Project
Earnings
Prepared By:_____________________________________________________________________________
Phone:______________________ Fax:____________________ Email:_____________________________
Return to: rcforms@dga.org
Phone: 310-289-2064
DIRECTORS GUILD OF AMERICA
Weekly Work List
Project: ______________________________________________________________
Week Start Date: ______________________Week End Date: ___________________
Signatory Company: ____________________________________________________
Contact Name: ________________________________________________________
Address: _____________________________________________________________
City/State/Zip: ________________________________________________________
Prepared By: __________________________________________________________
Phone: ________________________ Email: _________________________________
*Please differentiate between 2ADs, Second 2ADs & Add’l 2ADs, and identify Directors on 2
nd
Unit, or Added
Scenes/Retakes.
Name
SSN (last 4 digits)
Category*
Episode # (If applicable)
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Completed 4 January 2020

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