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
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Kimberly Wild |
File Modified | 0000-00-00 |
File Created | 2024-07-22 |