Document
FCC Form 1275 Certification for Open Video Systems
ICR 201810-3060-012 · OMB 3060-0700 · Object 87119701.
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3060-0700 can be found here:
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| Federal Communications Commission | OMB Control Number 3060-0700 | |||||
| Washington, D. C. 20554 | ||||||
| FCC FORM 1275 | ||||||
| CERTIFICATION FOR OPEN VIDEO SYSTEMS | ||||||
| A. Company Information | ||||||
| Company Name: | ||||||
| Contact Person: | ||||||
| Mailing Address: | ||||||
| City: | State: | Zip Code: | ||||
| Phone Number: | Fax Number: | |||||
| B. Attach a statement of ownership, including all affiliated entities | ||||||
| C. Eligibility and Compliance Representations | ||||||
| Yes | No | N/A | ||||
| 1. If you are a cable operator applying for certification within your cable franchise area, are you | ||||||
| qualified to operate an open video system under 47 C.F.R. § 76.1501? | ||||||
| 2. Do you agree to comply and to remain in compliance with each of the Commission's | ||||||
| regulations in 47 C.F.R. §§ 76.1503, 76.1504, 76.1506(m), 76.1508, 76.1509, and 76.1513? | ||||||
| 3. Do you agree to comply with the Commission's notice and enrollment requirements | ||||||
| for unaffiliated video programming providers? | ||||||
| 4. If applicable, do you agree to file changes to your cost allocation manual at least | ||||||
| 60 days before the commencement of service? | ||||||
| D. System Information | ||||||
| 1. Provide a general description of the anticipated communities or areas to be served upon completion of the system. | ||||||
| 2. Anticipated Digital Capacity: | 3. Anticipated Analog Capacity: | |||||
| 4. If Switched Digital, Anticipated Number of Channel Input Ports: | ||||||
| E. Verification Statement | ||||||
| WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT | ||||||
| (U.S. CODE TITLE 18, SECTION 1001), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503) | ||||||
| To the best of my knowledge and belief, the representations made herein are accurate according to the most recent information available. | ||||||
| Name: | Signature: | |||||
| Title: | Date: | |||||
| File Type | application/vnd.ms-excel |
| File Title | FCC Form 1275 Certification for Open Video Systems |
| Author | Shirley.Suggs |
| Last Modified By | Shirley.Suggs |
| File Modified | 2007-05-30 |
| File Created | 2004-03-25 |