Summary Statement Template printable pdf download

Summary Statement Form

[Instructions: This form to be completed and provided on your company letterhead]

(Today’s Date)

Florida Office of Film & Entertainment

107 East Madison Street, MSC80

Tallahassee, Florida 32399-0001

RE: Florida Entertainment Industry Financial Incentive Program Summary Statement

Dear Incentives Administrator:

On behalf of (Production Company) in reference to (Name of Production), fiscal year

Ending 6/30/20XX, the following apply:

1) Crew

___/___ were Floridians – ____%

Talent (CAST)

___/___ were Floridians – ____%

Extras and stand-ins ___/___ were Floridians – ____%

Project

___/___ were Floridians – ____%

2) Total Lodging Expenditures $_____________

Estimated Hotel Rooms

_____ nights

Estimated Condo/Residential Rental _____ nights

3) Total FL Qualified Expenditures(include FL qualified payroll) $_____________

Total Florida Expenditures (include both qualified and non-qualified expenditures) $_________________

Total FL Qualified Expenditures in an Underutilized Area $________________

Percentage of Qualified FL expenditures spent in Underutilized area______%

4) Total FL Qualified Payroll Expenditures Cast $_____________________

Total Pay Hours Cast _______________________

Total FL Qualified Payroll Expenditures Crew $_____________________

Total Pay Hours Crew _______________________

Total FL Qualified Payroll Expenditures Extras/Stand-Ins $_____________________

Total Pay Hours Extras/Stand-Ins _______________________

Total FL Qualified Payroll Expenditures Project $_____________________

Total Pay Hours Project_______________________

5) Number of FL Students/recent graduates hired ______________

Total wages paid to FL Students/recent graduates $___________

DSBD 1254-8 (10/13) - Page 1 of 2

Summary Statement Form

Florida Entertainment Industry Financial Incentive Program

Summary Statement Template