Form FCC Form 1240 FCC Form 1240 Updating Maximum Permitted Rates for Regulated Cable Ser

Federal Communications Commission
Washington, DC 20554

Approved by OMB 3060-0685

FCC FORM 1240
UPDATING MAXIMUM PERMITTED RATES FOR REGULATED CABLE SERVICES
Cable Operator:
Name of Cable Operator
Mailing Address of Cable Operator
City

State

ZIP Code
YES

NO

YES

NO

1. Does this filing involve a single franchise authority and a single community unit?
If yes, complete the franchise authority information
below and enter the associated CUID number here:
2. Does this filing involve a single franchise authority but multiple community units?
If yes, enter the associated CUIDs below and complete the franchise authority information at the bottom of this page:

3. Does this filing involve multiple franchise authorities?
If yes, attach a separate sheet for each franchise authority and include the following franchise authority information with
its associated CUID(s):
Franchise Authority Information:
Name of Local Franchising Authority
Mailing Address of Local Franchising Authority
City

State

Telephone number

Fax Number

ZIP Code

4. For what purpose is this Form 1240 being filed? Please put an "X" in the appropriate box.
a. Original Form 1240 for Basic Tier
b. Amended Form 1240 for Basic Tier
c. Original Form 1240 for CPS Tier
d. Amended Form 1240 for CPS Tier
TO

5. Indicate the one year time period for which you are setting rates (the Projected Period).

(mm/yy)
TO

6. Indicate the time period for which you are performing a true-up.

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Microsoft Excel 5.0 Version

(mm/yy)

FCC Form 1240
July 1996

Federal Communications Commission
Washington, DC 20554

Approved by OMB 3060-0685

8. Status of Previous Filing of FCC Form 1210 (enter an "x" in the appropriate box)
YES

NO

a. Has an FCC Form 1210 been previously filed with the FCC?
If yes, enter the date of the most recent filing:

(mm/dd/yy)
YES

NO

b. Has an FCC Form 1210 been previously filed with the Franchising Authority?
If yes, enter the date of the most recent filing:

(mm/dd/yy)

9. Status of FCC Form 1200 Filing (enter an "x" in the appropriate box)
YES

NO

a. Has an FCC Form 1200 been previously filed with the FCC?
If yes, enter the date filed:

(mm/dd/yy)
YES

NO

b. Has an FCC Form 1200 been previously filed with the Franchising Authority?
If yes, enter the date filed:

(mm/dd/yy)

10. Cable Programming Services Complaint Status (enter an "x" in the appropriate box)
YES

NO

a. Is this form being filed in response to an FCC Form 329 complaint?
If yes, enter the date of the complaint:

(mm/dd/yy)
YES

NO

11. Is FCC Form 1205 Being Included With This Filing
12. Selection of "Going Forward" Channel Addition Methodology (enter an "x" in the appropriate box)
Check here if you are using the original rules [MARKUP METHOD].
Check here if you are using the new, alternative rules [CAPS METHOD].
If using the CAPS METHOD, have you elected to revise recovery for
channels added during the period May 15, 1994 to Dec. 31, 1994?

YES

NO

13. Headend Upgrade Methodology
*NOTE: Operators must certify to the Commission their eligibility to use this upgrade methodology and attach an equipment list and depreciation schedule.

Check here if you are a qualifying small system using the streamlined headend upgrade methodology.

Part I: Preliminary Information
Module A: Maximum Permitted Rate From Previous Filing
Line Description

Line
A1

a
Basic

b
Tier 2

c
Tier 3

d
Tier 4

e
Tier 5

c
Tier 3

d
Tier 4

e
Tier 5

Current Maximum Permitted Rate

Module B: Subscribership
Line Description

Line
B1

Average Subscribership For True-Up Period 1

B2

Average Subscribership For True-Up Period 2

Page 2

a
Basic

b
Tier 2

Microsoft Excel 5.0 Version

FCC Form 1240
July 1996

Federal Communications Commission
Washington, DC 20554

Approved by OMB 3060-0685
a
Basic

Line Description

Line
D1

Current Headend Upgrade Segment

D2

Current External Costs Segment

D3

Current Caps Method Segment

D4

Current Markup Method Segment

D5

Current Channel Movement and Deletion Segment

D6

Current True-Up Segment

D7

Current Inflation Segment

D8

Base Rate [A1-D1-D2-D3-D4-D5-D6-D7]

b
Tier 2

c
Tier 3

d
Tier 4

e
Tier 5

d
Tier 4

e
Tier 5

d
Tier 4

e
Tier 5

Part II: True-Up Period
Module E: Timing Information
Line Description

Line
E1

What Type of True-Up Is Being Performed? (Answer "1", "2", or "3". See Instructions for a description of these types.)
If "1", go to Module I. If "2", answer E2 and E3. If "3", answer E2, E3, E4, and E5.

E2

Number of Months in the True-Up Period 1

E3

Number of Months between the end of True-Up Period 1 and the end of the most recent Projected Period

E4

Number of Months in True-Up Period 2 Eligible for Interest

E5

Number of Months True-Up Period 2 Ineligible for Interest

Module F: Maximum Permitted Rate For True-Up Period 1
Line Description

Line
F1

Caps Method Segment For True-Up Period 1 [Wks 2]

F2

Markup Method Segment For True-Up Period 1 [Wks 3]

F3

Chan Mvmnt Deletn Segment For True-Up Period 1 [Wks' 4/5]

F4

True-Up Period 1 Rate Eligible For Inflation [D8+F1+F2+F3]

F5

Inflation Segment for True-Up Period 1 [(F4*C3)-F4]

F6

Headend Upgrade Segment For True-Up Period 1 [Wks 6]

F7

External Costs Segment For True-Up Period 1 [Wks 7]

F8

True-Up Segment For True-Up Period 1

F9

Max Perm Rate for True-Up Period 1 [F4+F5+F6+F7+F8]

a
Basic

b
Tier 2

c
Tier 3

Module G: Maximum Permitted Rate For True-Up Period 2
Line Description

Line
G1

Caps Method Segment For True-Up Period 2 [Wks 2]

G2

Markup Method Segment For True-Up Period 2 [Wks 3]

G3

Chan Mvmnt Deletn Segment For True-Up Period 2 [Wks' 4/5]

G4

TU P i d 2 R t Eli ibl F

Page 3

I fl ti

a
Basic

b
Tier 2

c
Tier 3

[D8+F5+G1+G2+G3]

Microsoft Excel 5.0 Version

FCC Form 1240
July 1996

Federal Communications Commission
Washington, DC 20554

Approved by OMB 3060-0685

Module H: True-Up Adjustment Calculation
a
Basic

Line Description
Line
Adjustment For True-Up Period 1
H1

Revenue From Period 1

H2

Revenue From Max Permitted Rate for Period 1

H3

True-Up Period 1 Adjustment [H2-H1]

H4

Interest on Period 1 Adjustment

b
Tier 2

c
Tier 3

d
Tier 4

e
Tier 5

d
Tier 4

e
Tier 5

Adjustment For True-Up Period 2
H5

Revenue From Period 2 Eligible for Interest

H6

Revenue From Max Perm Rate for Period 2 Eligible For Interest

H7

Period 2 Adjustment Eligible For Interest [H6-H5]

H8

Interest on Period 2 Adjustment (See instructions for formula)

H9

Revenue From Period 2 Ineligible for Interest

H10 Revenue From Max Perm Rate for Period 2 Ineligible for Interest
H11 Period 2 Adjustment Ineligible For Interest [H10-H9]
Total True-Up Adjustment
H12 Previous Remaining True-Up Adjustment
H13 Total True-Up Adjustment [H3+H4+H7+H8+H11+H12]
H14 Amount of True-Up Claimed For This Projected Period
H15 Remaining True-Up Adjustment [H13-H14]

Part III: Projected Period
Module I: New Maximum Permitted Rate
Line Description

Line
I1

Caps Method Segment For Projected Period [Wks 2]

I2

Markup Method Segment For Projected Period [Wks 3]

I3

Chan Mvmnt Deletn Segment For Projected Period [Wks 4/5]

I4

Proj. Period Rate Eligible For Inflation [D8+F5+G5+I1+I2+I3]

I5

Inflation Segment for Projected Period [(I4*C5)-I4]

I6

Headend Upgrade Segment For Projected Period [Wks 6]

I7

External Costs Segment For Projected Period [Wks 7]

I8

True-Up Segment For Projected Period

I9

Max Permitted Rate for Projected Period [I4+I5+I6+I7+I8]

I10

Operator Selected Rate For Projected Period

a
Basic

b
Tier 2

c
Tier 3

Note: The maximum permitted rate figures do not take into account any refund liability you may have. If you have previously been ordered by the Commission or your
local franchising authority to make refunds, you are not relieved of your obligation to make such refunds even if the permitted rate is higher than the contested rate or
your current rate

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Microsoft Excel 5.0 Version

FCC Form 1240
July 1996