Public Information Campaign ( Radio PSA)

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statement.
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Please take a moment to complete the following information. It will help
us determine the kind of PSAs you want to receive in the future. What is
your preferred audio format? (i.e. - .mp3 •.wav files). _ _ _ __
Thank you for your cooperation and support.

o Check here if you need a new CD.
Title

#Times Per
Week Aired

#Weeks Aired

"Retiring Online Is Easy"
:30 PSA

1·3 4-6 7-9 10-12 16+

1-3 4-6 7-9 10-12 16+

"So Easy a Beatnik Can Do It"
:30 PSA

IName:
ICall Letters:
ITelephone:
IAddress:
ICity

1-3 4-6 7-9 10-12 16+

1-3 4-6 7-9 10-12 16+

FM

AM
Fax:
State

Zip

....~---... ~--------

The following revised PRA Statement will be inserted into the form at its
next scheduled reprinting:
Paperwork Reduction Act Statement - This information collection meets the
requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer these questions unless we display a valid Office
of Management and Budget control number. We estimate that it will take about 1 minute
to read the instructions, gather the facts, and answer the questions. Send only comments
relating to our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 212356401.