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Broadcast Statement Of Compliance 397 - Official Federal Forms
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Federal Communications Commission Approved by OMBWashington, D. C. 20554 3060-0922 BROADCAST STATEMENT (For FCC Use Only) OF COMPLIANCE Code No. Legal Name of the Licensee Mailing Address City State or Country (if foreign address) ZIP Code Telephone Number (include area code) E-Mail Address (if available) Facility ID Number Call Sign TYPE OF BROADCAST STATION : Commercial Broadcast Station Noncommercial Broadcast Station Radio TV Educational Radio Low Power TV Educational TV International List call sign and location of all stations included on this statement. List commonly owned stations that share one or more employees. Also list stations operated by the licensee pursuant to a time brokerage agreement. Indicate on the table below which stations are operated pursuant to a time brokerage agreement. To the extent that licensees include stations operated pursuant to a time brokerage agreement on this report, responses or information provided in Sections I through III should take into consideration the licensees EEO compliance efforts at brokered stations, as well as any other stations, included on this form. For purposes of this form, a station employment unit is a station or a group of commonly owned stations in the same market that share at least one employee. Time Brokerage Type Location Call Sign Facility ID Number Agreement (check applicable box) (city, state) (check applicable box) AM FM TV Yes No AM FM TV Yes No AM FM TV Yes No AM FM TV Yes No AM FM TV Yes No AM FM TV Yes No AM FM TV Yes No AM FM TV Yes No AM FM TV Yes No FCC 397 April 2000 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2SEND NOTICES AND COMMUNICATIONS TO THE FOLLOWING NAMED PERSON AT THE ADDRESS INDICATED BELOW: Name Street Address City State Zip Code Telephone No. ( ) FILING INSTRUCTIONS Broadcast station licensees are required to afford equal employment opportunity to all qualified persons and to refrain from discriminating in employment and related benefits on the basis of race, color, national origin, religion, and sex. See 47 C.F.R. Section 73.2080. Pursuant to these requirements, a station employment unit that employs five or more full-time station employees must file a statement of compliance with equal employment opportunity requirements. If a station employment unit employs fewer than five full-time employees, no statement need be filed. A copy of this statement must be kept in the stations public file. Failure to meet these requirements may result in sanctions orremedies. These requirements are contained in 47 C.F.R. Section 73.2080 and are authorized by the Communications Act of 1934, as amended. Does your station employment unit employ fewer than five full-time employees? Yes NoConsider as "full-time" employees all those permanently working 30 or more hours a week. If your station employment unit employs fewer than five full-time employees, complete the certification below, return the form to theFCC, and place a copy in your station(s) public file. You do not have to complete the rest of this form. If your station employmentunit employs five or more full-time employees, you must complete all of this form and follow all instructions. CERTIFICATION This report must be certified, as follows: A. By licensee, if an individual; B. By a partner, if a partnership (general partner, if a limited partnership); C. By an officer, if a corporation or an association; or D. By an attorney of the licensee, in case of physical disability or absence from the United States of the licensee. WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503). I certify to the best of my knowledge, information and belief, all statements contained in this report are true and correct. Signed Name of Respondent Title Telephone No. (include area code) Date FCC 397 (Page 2) April 2000 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3The purpose of this document is to provide broadcast licensees, the FCC, and the public with information about whether the station is meeting equal employment opportunity requirements. GENERAL POLICY A broadcast station must provide equal employment opportunity to all qualified individuals without regard to their race, color,national origin, religion or sex in all personnel actions including recruitment, evaluation, selection, promotion, compensation,training and termination. RESPONSIBILITY FOR IMPLEMENTATION A broadcast station must assign a particular official overall responsibility for equal employment opportunity at the station. Thatofficials name and title are: NAME TITLE It is also the responsibility of all persons at a broadcast station making employment decisions with respect to recruitment, evaluation,selection, promotion, compensation, training and termination of employees to ensure that no person is discriminated against inemployment because of race, color, religion, national origin or sex. I. STATEMENT OF COMPLIANCE The station(s) has complied with the outreach provisions of the FCCs Broadcast Equal Yes No See ExplanationEmployment Opportunity Rule, 47 C.F.R. Section 73.2080, during the two-year period prior to in Exhibit No.filing this form. II. RECRUITMENT ELECTION Please indicate which option the station employment unit will utilize for the next two years. See 47 C.F.R. Section 73.2080 of the Commissions Rules. Supplemental Recruitment Measures (Option A) Alternative Recruitment Option (Option B) III. MID-TERM REVIEW Television station employment units with five or more full-time employees and radio station employment units with more than tenfull-time employees filing in the middle of the license term must attach a copy of the EEO public file report from the previous year. Stations are required to place annually such information as is required by 47 C.F.R. Section 73.2080 in their public files. FCC NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT AND THE PAPERWORK REDUCTION ACT The FCC is authorized under the Communications Act of 1934, as amended, to collect the personal information we request in this report. We will use theinformation you provide to determine if the benefit requested is consistent with the public interest. If we believe there may be a violation or potential violation of aFCC statute, regulation, rule
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