ࡱ> uwt  $bjbj "njj Aldddd8dd$\ \ \ \  '|"""""""$$ &"# " "#W\ \ #WWWN8\ \ "NW"WWV\  @<dd #0$ 'r'W, LCandidate Agreement Form for Political Advertisements Station and Location:  FORMTEXT       Date:  FORMTEXT      , 2006 I,  FORMTEXT       , [check one:]  FORMCHECKBOX  being  FORMCHECKBOX  on behalf of:  FORMTEXT       , a legally qualified candidate of the  FORMTEXT       political party for the office of  FORMTEXT      in the  FORMTEXT      election to be held on  FORMTEXT       do hereby request station time as follows: Date of BroadcastClass of TimeTime of Day, Rotation or PackageLengthRate FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       I represent that the candidate named above has authorized the announcements ordered above to be broadcast pursuant to the terms of this agreement. Each announcement must include a statement that it is paid for or sponsored by, and then name the sponsor (i.e.: the candidate or his/her campaign committee). In addition, if the announcement is on behalf of a candidate for Federal office: (a)it must include a statement read by the candidate that identifies the candidate by name and states that the candidate approved the broadcast, (b) any radio broadcast must include the office being sought, and (c) any television broadcast must conclude with at least a four-second segment consisting of either an unobscured view of the candidate making the required statement or the candidates voice accompanied by a clearly identifiable photographic or similar image of the candidate, together with a clearly readable printed text of the statement. The image must be at least 80% of screen height and the text must be in letters at least 4% of screen height and must reasonably contrast with the background. The payment for the above described broadcast time has been furnished by the following:  FORMTEXT       You are authorized to announce the time as paid for by such person or entity. The entity or person furnishing the payment for this announcement is either a legally qualified candidate or an authorized committee/organization of the legally qualified candidate. Treasurer s name of the candidate s authorized committee:  FORMTEXT       This application, whether accepted or rejected, will remain available for public inspection for a period of at least two years.  FORMCHECKBOX  Check here if Lowest Unit Rates are requested for broadcasts on behalf of a candidate for Federal office within 60 days of a general election or 45 days of a primary election. If this box is checked, then I certify that any broadcast containing a direct reference to another candidate for the same office will include in the candidate announcement described above identification of the office sought or, if a televised announcement, a statement that the candidates authorized committee paid for the broadcast. I understand that a failure to include an appropriate candidate statement within the announcement may result in forfeiture of entitlement to lowest unit rates for the remainder of the campaign.  FORMCHECKBOX  I hereby acknowledge that I have received and understand the stations rate guide titled FORMTEXT      , issued on  FORMTEXT      . 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" "$"&":"ѹj.Uj-Uj2-Uj,Uj>*UmHnHujF,>*U>* j>*UNH6]j+UjUmHnHu jUjZ+U9@hrRPNNNNHN $$$IfTlr $8 {|064 lar @!N"P"R""""""=$$Ifl$$ t$644 la$If $ :"<">"H"J"R"""6#v#x#z#|##########$ $ $CJaJCJ5\jUmHnHu jUj.U""""""l/c$$IflFz$>  t$6    44 la$Ife$$IflFz$>   t$6    44 la""6#8#:#<#>#@#h#j#Sle$$IflFz$>   t$6    44 la=$$Ifl$$ t$644 la$If j#t#v#z#~######### $ $ $ $$a$c$$IflFz$>  t$6    44 la$If 1h/ =!"#$8%DText12Fill in Station Call Sign and Community of LicenseDText2 MMMM d, yyyy4Type mm/dd/yyy and the text equivalent will be addedtDText3tDeCheck1tDeCheck2tDText4tDText5tDText6tDText7DText18 MMMM d, yyyyDText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13DText9M/d/yyyyM/d/yyyyvDText10vDText11vDText12vDText13vDText14vDText15tDeCheck3tDeCheck4vDText16DText17 MMMM d, yyyy iF@F Normal$a$ CJOJQJ_HaJmH sH tH PP  Heading 1"$$ & F 7$8$@&H$a$ 5\aJ FF  Heading 2$ & F 7$8$@&H$ \]aJD@D Heading 3$$@&a$5CJ\aJ<A@< Default Paragraph Font.. 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