Application Form For Class A Television Broadcast Station Page 6

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If you do not provide the information requested on this form, the application may
be returned without action having been taken upon it or its processing may be
delayed while a request is made to provide the missing information. Your
response is required to obtain the requested authorization.
We have estimated that each response to this collection of information will take 2
hours. Our estimate includes the time to read the instructions, look through
existing records, gather and maintain the 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 (3060-0928), Washington, DC 20554. We will
also accept your comments via the Internet if you send them to jboley@fcc.gov.
Please DO NOT SEND COMPLETED APPLICATIONS TO THIS
ADDRESS. 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 of if we fail to provide you with this notice. This collection has
been assigned an OMB control number of 3060-0928.
THE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT
OF 1974, P.L. 93-579, DECEMBER 31, 1974, 5 U.S.C. 552a(e)(3), AND
THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13,
OCTOBER 1, 1995, 44 U.S.C. Section 3507.
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