FCC Form 395 Common Carrier Annual Employment Report

FCC 395

FEDERAL COMMUNICATIONS COMMISSION
Washington, DC 20554

Approved by OMB
3060-0076
Est. time per response:
1 hour

COMMON CARRIER ANNUAL EMPLOYMENT REPORT
[Please read instructions before completing and for Notice regarding public burden.]
SECTION 1 - General Information
1. Name and Mailing Address of Respondent
__ Check here if this
is a change of
address.

2. Year Report Filed

3. Reporting Period (Ending Date of Pay
Period Covered by Report)

4. Number of Full-Time Employees during Selected
Reporting Period (check one):
a. __ Fewer than 16 (complete Sections I, IV, and V only)
b. __ 16 or more (complete all sections)

SECTION II - Full-Time Employees.
Number of Employees
(Report employees in only one category)
Race/Ethnicity

Job
Categories

Not-Hispanic or Latino

Hispanic or
Latino
Male

Executive/Senior Level
Officials and Managers

1.1

First/Mid-Level Officials and
Managers

1.2

Professionals

2

Technicians

3

Sales Workers

4

Administrative Support
Workers

5

Craft Workers

6

Operatives

7

Laborers and Helpers

8

Service Workers

9

TOTAL

10

PREVIOUS YEAR TOTAL

11

Total
Columns
A-N

Female

Male

Female

White

Black or
African
American

Native
Hawaiian or
Other
Pacific
Islander

Asian

American
Indian or
Alaska
Native

Two or more
races

White

Black or
African
American

Native
Hawaiian or
Other
Pacific
Islander

Asian

American
Indian or
Alaska
Native

Two or more
races

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

FCC 395
Revised December 2007

SECTION III - Part-Time Employees.
Number of Employees
(Report employees in only one category)
Race/Ethnicity

Job
Categories

Not-Hispanic or Latino

Hispanic or
Latino
Male

Executive/Senior Level
Officials and Managers

1.1

First/Mid-Level Officials and
Managers

1.2

Professionals

2

Technicians

3

Sales Workers

4

Administrative Support
Workers

5

Craft Workers

6

Operatives

7

Laborers and Helpers

8

Service Workers

9

TOTAL

10

PREVIOUS YEAR TOTAL

11

Total
Columns
A-N

Female

Male

Female

White

Black or
African
American

Native
Hawaiian or
Other
Pacific
Islander

Asian

American
Indian or
Alaska
Native

Two or more
races

White

Black or
African
American

Native
Hawaiian or
Other
Pacific
Islander

Asian

American
Indian or
Alaska
Native

Two or more
races

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

SECTION IV - Report of Discrimination Complaints Pursuant to 47 CFR 22.321, 23.55, 90.168, 101.4, and 101.311.
_____ This is to advise the Commission that no complaints regarding violations of the equal employment provisions of Federal, state, territorial, or local statutes have been filed against this
company before any body having competent jurisdiction in such matters during the calendar year covered by this report.
_____ This is to advise the Commission that the following complaints alleging violations of the provisions of any equal employment opportunity statute have been filed against this company.
(Attach a list indicating parties involved, date filed, courts or agencies before which the matter has been heard, file number or other designation, and current status or disposition.
SECTION V - Certification
I certify that to the best of my knowledge, information, and belief, all statements in this report are true and correct.
Date

Title of Person Signing

Typed or Printed Name of Person Signing

Signature

Telephone No.

WILLFULLY FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (18 U.S.C. 1001) AND/OR REVOCATION
OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (47 U.S.C. 312 (A)(1) AND/OR FORFEITURE (47 U.S.C. 503).
FCC 395
Revised December 2007