06/02/17
City of Moorpark Film Permit #: _________
Film Permit Application Date Submitted: ___________
(Application must be submitted at least four (4) weeks in advance for public property and/or city
right-of-away filming, and two (2) weeks in advance for private property prior to filming activity)
Production Information
Company Name: ______________________________________________________________________
Address: ____________________________________________________________________________
Unit Production Manager: _______________________ or Production Manager: ____________________
Cell Phone: _______________________________________ Office: ____________________________
Fax: ______________________________ Email: ____________________________________________
Contact Person: ________________________________ Title: _________________________________
Cell Phone: _______________________________________ Office: ____________________________
Fax: ______________________________ Email: ____________________________________________
*Please note: At least one contact person must be on site and available to City staff during the filming period.
Location Information
Production Title: ______________________________________________________________________
Type of film:
Prep Date(s) and Time(s): ______________________________________________________________
Filming Date(s) and Time(s): ____________________________________________________________
Hold Date(s) and Time(s): ______________________________________________________________
Strike Date(s) and Time(s): _____________________________________________________________
If YES on any of the above questions, please explain _________________________________________
___________________________________________________________________________________
Number of Vehicles/Equipment: Cars _______ Vans _______ Trucks ________ Camera Cars________
Motor Homes / Trailers ______ other (specify) ______________________________
Number of Personnel: Cast _______ Crew _______ Extras _______ Total _______
___________________ ________________________________ ___________
Print Name Signature Date
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