Withdrawal Request Form You must be a Full Member in good standing for at least one full year before you can place your membership on withdrawal. Going on withdrawal puts your membership “on hold”, prevents the accumulation of annual dues and makes reactivating your membership simple and less expensive. The cost of going on withdrawal is $48.75 (25% of the annual basic dues). MEMBERS ON WITHDRAWAL: may not work in ACTRA’s jurisdiction nor do non-union work, pay a 10% fee for any commercial residual cheques you receive, and, ACTRA Performers’ Rights Society (PRS) will deduct a 25% service charge from your Use fee and royalty payments. may find that their benefit plan with AFBS is affected by going on withdrawal. Please contact AFBS at (416)967-6600 HOW TO GO ON WITHDRAWAL: Complete and submit this form. You will be contacted by ACTRA Toronto Membership staff to confirm your decision and to arrange payment of the $48.75 withdrawal fee. Payment can be made by Visa, Mastercard or Visa Debit, or cheque. ACTRA ID* ACTRA Toronto Membership Number (as it appears on your card (99-99999)Name* First Last Your stage name as it appears on your ACTRA Toronto Membership Card.STATEMENT OF INTENT TO WITHDRAW AND ACCEPTANCE OF TERMSBy clicking on the button below, I confirm that I am a full member in good standing with dues paid up and that I am making an application to go on withdrawal. I have read the above and understand that I will be charged services charges on commercial and Performers’ Rights Society (PRS) cheques and that my benefits may be affected. I will reactivate my membership and pay the pro-rated dues upon my next engagement in ACTRA’s jurisdiction.Click to Agree* Agree Click the radio button to confirm your request to go on withdrawal and that you have read and understand the terms above.