Statement Of Account For Secondary Transmissions By Cable Systems (Short Form) {SA1-2}

SA1-2 - STATEMENT OF ACCOUNT for Secondary Transmissions by Cable Systems (Short Form). USE THIS FORM WHEN: • You are the owner (or represent the owner) of a cable system; and • You are filing the semiannual statement of account required by the copyright law; and • Your system’s semiannual gross receipts for secondary transmissions (the figure you give in space K of the form) is less than $527,600; and • You are also depositing the required semiannual royalty fee with the Licensing Section of the Copyright Office. IF YOUR FIGURE FOR SEMIANNUAL GROSS RECEIPTS IN SPACE K IS $527,600 OR MORE, USE SA3 (LONG FORM) www.FormsWorkflow.com