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pdfNOTICE TO FILERS OF FCC FORM 395
EFFECTIVE SEPTEMBER 1, 2016, RESPONDENTS MUST FILE ALL FCC FORM 395 REPORTS,
INCLUDING RESUBMISSIONS, IN WC DOCKET NO. 16-233 USING THE COMMISSION’S
ELECTRONIC COMMENT FILING SYSTEM (ECFS). 1
NOTE: DO NOT SUBMIT CONFIDENTIAL DOCUMENTS USING ECFS. CONFIDENTIAL
DOCUMENTS MUST BE SUBMITTED ON PAPER TO THE OFFICE OF THE SECRETARY. ALL
DOCUMENTS SUBMITTED THROUGH ECFS ARE MADE AVAILABLE TO THE PUBLIC.
All requests for confidential treatment of FCC Form 395 data should be filed consistent with Section 0.459 of the
Commission’s rules, 47 CFR § 0.459. A carrier seeking confidential treatment of certain Form 395 data must file a
redacted (public) version of its Form 395 Report using ECFS, and also file a non-redacted version, for which
confidentiality is requested, along with respondent’s request for confidentiality, with the Federal
Communications Commission, Office of the Secretary, 9050 Junction Drive, Annapolis Junction, MD 20701.
For a complete set of FCC Form 395 instructions, see https://www.fcc.gov/licensing-databases/forms. A Form 395,
which is fillable in the Acrobat reader, follows this page.
1
See Wireline Competition Bureau Announces Transition of FCC Form 395 Common Carrier Annual Employment
Report to Electronic Filing, Public Notice, DA 16-965, August 26, 2016.
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
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
Executive/Senior Level
Officials and Managers
1.1
0
First/Mid-Level Officials and
Managers
1.2
0
Professionals
2
0
Technicians
3
0
Sales Workers
4
0
Administrative Support
Workers
5
0
Craft Workers
6
0
Operatives
7
0
Laborers and Helpers
8
0
Service Workers
9
0
TOTAL
10
PREVIOUS YEAR TOTAL
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
CLEAR THIS PAGE
FCC 395
Revised [Month] 2021
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
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
Executive/Senior Level
Officials and Managers
1.1
0
First/Mid-Level Officials and
Managers
1.2
0
Professionals
2
0
Technicians
3
0
Sales Workers
4
0
Administrative Support
Workers
5
0
Craft Workers
6
0
Operatives
7
0
Laborers and Helpers
8
0
Service Workers
9
0
TOTAL
10
PREVIOUS YEAR TOTAL
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 [Month] 2021
CLEAR THIS PAGE
| File Type | application/pdf |
| Author | Cathy Zima |
| File Modified | 2021-04-20 |
| File Created | 2016-08-24 |