Radio Complaints OMB 3060-0874 FINAL 3 25 24

Product: Radio

Not Yet Approved by OMB 3060-0874 (Estimated average burden per person is 15 minutes.)

Privacy Statement

Email address

Subject

Description

Radio issues

Availability

Billing

Commercials/promotions

Emergency Alert System

Equipment

Indecency

Interference

From CB

From amateur radio

To home electronics equipment

To licensed radio services (land mobile, aviation, marine)

To personal radio services (CB, FRS, GMRS)

To non-licensed low powered devices (remote controls, key fobs, Bluetooth)

Pirate/unauthorized operation

Radio method

Date of your issue/problem

Time of your issues/problem

City where program was viewed/heard

State where program was viewed/heard

Name of program or DJ

Call sign or radio station name

Account number

First name

Last name

City

State

Zip code

Phone (where you can be contacted)

Filing on behalf of someone

No

Yes

Your relationship (on behalf of)

First name (on behalf of)

Last name (on behalf of)

City (on behalf of)

State (on behalf of)

Zip code (on behalf of)

Age of Complaint Filer

Under 18

18-24

25-34

35-44

45-54

55-64

65 or older

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Race - Select one or more:

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Primary language spoken at home – Select one or more:

English

Spanish

Chinese

French

Tagalog

Vietnamese

German

Korean

Other

Total Household Income

0-$20,000

$20,001-60,000

$60,001 - $100,000

$100,001 - $150,000

$150,001+

Housing

Multi-Unit Building(Apartment or Condo)

Single Family Home(House, Mobile Home, Townhome)

Other

Attestation

Can the FCC share your description (minus PII) of your complaint with the public on our website? y/n

Attachments