STUNT QUESTIONNAIRE
POLICY HOLDER INFORMATION (if applicable)
Insured name: *
Your answer
Policy number:
Your answer
PRODUCTION DETAILS
Production Title: *
Your answer
Production Type: *
Your answer
If Music Video, please indicate artist’s name:
Your answer
Music genre:
Your answer
Total Production Budget: *
Your answer
Start Production Date: *
MM
/
DD
/
YYYY
End Production Date: *
MM
/
DD
/
YYYY
Total number of days:
Your answer
Filming location:
Your answer
Please provide a detailed synopsis of the shoot: *
Your answer
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