Section I
Does your
station employment unit employ fewer than five full-time employees,
if television, or fewer than eleven full-time employees, if radio?
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Yes
No |
If yes, you do not have to file this form
with the FCC. However, you have the option to complete the certification
below, return the form to the FCC, and place a copy in your station(s)
public file. You do not have to complete the rest of this form. If your
station employment unit employs five or more full-time employees, if
television, or eleven or more full-time employees, if radio, 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.
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