Federal Communications Commission
Washington, D. C. 20554
Approved by OMB
BROADCAST EQUAL EMPLOYMENT
OPPORTUNITY PROGRAM REPORT
(To be filed with broadcast license renewal application)
(For FCC Use Only)
Legal Name of the Licensee
State or Country (if foreign address)
Telephone Number (include area code)
E-Mail Address (if available)
Facility ID Number
TYPE OF BROADCAST STATION :
Commercial Broadcast Station
Noncommercial Broadcast Station
Low Power TV
List call sign and location of all stations included on this report. List commonly owned stations that share one or more employees.
Also list stations operated by the licensee pursuant to a time brokerage agreement. Indicate on the table below which stations are
operated pursuant to a time brokerage agreement. To the extent that licensees include stations operated pursuant to a time brokerage
agreement on this report, responses or information provided in Sections I through IV should take into consideration the licensee's
EEO compliance efforts at brokered stations, as well as any other stations, included on this form. For purposes of this form, a
station employment unit is a station or a group of commonly owned stations in the same market that share at least one employee.
Facility ID Number
(check applicable box)
(check applicable box)
CONTACT PERSON IF OTHER THAN LICENSEE
Broadcast station licensees are required to afford equal employment opportunity to all qualified persons and to refrain from
discriminating in employment and related benefits on the basis of race, color, national origin, religion, and sex. See 47 C.F.R.
Section 73.2080. Pursuant to these requirements, a license renewal applicant whose station employment unit employs five or more
full-time station employees must file a report of its activities to ensure equal employment opportunity. If a station employment unit
employs fewer than five full-time employees, no equal employment opportunity program information need be filed. If a station
employment unit is filing a combined report, a copy of the report must be filed with each station's renewal application.
A copy of this report must be kept in the station's public file. These actions are required to obtain license renewal. Failure to meet
these requirements may result in sanctions or license renewal being delayed or denied. These requirements are contained in 47
C.F.R. Section 73.2080 and are authorized by the Communications Act of 1934, as amended.
DISCRIMINATION COMPLAINTS. Have any pending or resolved complaints been filed during this
license term before any body having competent jurisdiction under federal, state, territorial or local law,
alleging unlawful discrimination in the employment practices of the station(s)?
If so, provide a brief description of the complaint(s), including the persons involved, the date of the filing,
the court or agency, the file number (if any), and the disposition or current status of the matter.
Does your station employment unit employ fewer than five full-time employees?
If your station employment unit employs fewer than five full-time employees, 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, you must complete all of this form and follow all instructions.
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.
Name of Respondent
Telephone No. (include area code)
FCC 396 (Page 2)
The purpose of this document is to provide broadcast licensees, the FCC, and the public with information about whether the
station is meeting equal employment opportunity requirements.
A broadcast station must provide equal employment opportunity to all qualified individuals without regard to their race, color,
national origin, religion or sex in all personnel actions including recruitment, evaluation, selection, promotion, compensation,
training and termination.
RESPONSIBILITY FOR IMPLEMENTATION
A broadcast station must assign a particular official overall responsibility for equal employment opportunity at the station. That
official's name and title are:
It is also the responsibility of all persons at a broadcast station making employment decisions with respect to recruitment,
evaluation, selection, promotion, compensation, training and termination of employees to ensure that no person is discriminated
against in employment because of race, color, religion, national origin or sex.
I. EEO PUBLIC FILE REPORT
Attach as an exhibit one copy of each of the EEO public file reports from the previous two
years. Stations are required to place annually such information as is required by 47 C.F.R.
Section 73.2080 in their public files.
II. NARRATIVE STATEMENT
Provide a statement in an exhibit which demonstrates how the station achieved broad and
inclusive outreach during the two-year period prior to filing this application. Stations that have
experienced difficulties in their outreach efforts should explain.
FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT
We have estimated that each response to this collection of information will take 1.5 hours. Our estimate includes the time to read the
instructions, look through existing records, gather and maintain required data, and actually complete and review the form or
response. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you,
please write the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0113), Washington, D.
C. 20554. We will also accept your comments via the Internet if you send them to [email protected] Remember - you are not required
to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this
collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has
been assigned an OMB control number of 3060-0113.
THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13,
OCTOBER 1, 1995, 44 U.S.C. 3507.
FCC 396 (Page 3)