ASCAP: Form AB-96

<body bgcolor="#FFFFFF"> <CENTER> <h2>ASCAP Annual Statement of Account Blanket</h2> <form method="POST" action="/cgi-bin/forms/ab_confirm.cgi"> <hr> <table width=640> <tr> <th bgcolor="#fff07b" colspan=2>Submitted by:</th> </tr> <tr> <td><b>Name:</b><br> <input type=text name=submitter size=20> </td> <td><b>Title:</b><br> <input type=text name=title size=20> </td> </tr> <tr> <td><b>Account Number:</b> <a href="blanket_help.html#account" target="help"><img src="info.gif" border=0 vspace=2 align=top></a><br> <input type=text size=20 name=account_number onChange=validate_memb_num(this)> </td> <td><b>Requested Document Format:</b> <a href="blanket_help.html#format" target="help"><img src="info.gif" border=0 vspace=2 align=top></a><br> <select name=doc_format> <option selected>Adobe Portable Document Format (PDF) viewed with plug-in</option> <option>Adobe Portable Document Format (PDF) saved to disk</option> <option>PostScript (PS)</option> </select> </td> </tr> </table> <p> <table border="0" width=640> <tr> <th bgcolor="#fff07b">Reporting Period <a href="blanket_help.html#reporting" target="help"><img src="info.gif" border=0 vspace=2 align=top></a></td> <th bgcolor="#fff07b" colspan=3>Station Covered by This Report <a href="blanket_help.html#type" target="help"><img src="info.gif" border=0 vspace=2 align=top></a></td> </tr> <tr> <td align="center" rowspan=2>Calendar Year Basis <select name=cal_year> <option selected> </option> <option>1996</option> <option>1997</option> <option>1998</option> <option>1999</option> <option>2000</option> </select> <p> If less than full year Reporting Period:<br> <input type="text" size="2" maxlength=2 name="start_month"> / <input type="text" size="2" maxlength=2 name="start_day"> / <input type="text" size="2" maxlength=2 name="start_year"> (Month/Day/Year) <br> to <br> <input type="text" size="2" maxlength=2 name="end_month"> / <input type="text" size="2" maxlength=2 name="end_day"> / <input type="text" size="2" maxlength=2 name="end_year"> (Month/Day/Year) </td> <td></td> <td valign="top" align="center"> <strong>AM</strong> <input type="radio" name="station_type" value="AM"> </td> <td valign="top" align="center"> <strong>FM</strong> <input type="radio" name="station_type" value="FM"> </td> </tr> <tr> <td valign="top" align=right> Call Letters: <br> Licensee<br> Address </td> <td valign=top colspan=2> <input type="text" size="8" maxlength=4 name="call_letters" onChange=validate_station(this)><br> <input type="text" size="30" name="licensee"><br> <textarea name="address" rows=2 cols="30"></textarea> </td> </tr> </table> <p> <table border=0 width=100%> <tr> <th colspan="2" bgcolor="#fff07b">Other Stations covered by this Report <a href="blanket_help.html#other_stations" target="help"><img src="info.gif" border=0 vspace=2 align=top></a></td> </tr> <tr> <td align=center valign=top> Co-Owned stations<br><font size=-1>(80% simulcast or < 75,000 gross)</font> </td> <td align=center valign=top>Time Broker for:</td> </tr> <tr> <td align="center"> <input type="text" size=8 maxlength=4 name="co1a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co1b"onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co2a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co2b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co3a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co3b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co4a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co4b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co5a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co5b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co6a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co6b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co7a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co7b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co8a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co8b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co9a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co9b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co10a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co10b" onChange=validate_station_type(this)><br> </td> <td align=center> <input type="text" size=8 maxlength=4 name="co11a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co11b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co12a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co12b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co13a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co13b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co14a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co14b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co15a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co15b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co16a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co16b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co17a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co17b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co18a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co18b" onChange=validate_station_type(this)><br> <input type="text" size=8 maxlength=4 name="co19a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co19b" onChange=validate_station_type(this)> <input type="text" size=8 maxlength=4 name="co20a" onChange=validate_station(this)> -<input type="text" size=3 maxlength=2 name="co20b" onChange=validate_station_type(this)><br> </td> </tr> </table> <p> <table border=0 width=100%> <tr> <th bgcolor="#fff07b" colspan=2>Accounting Method: <a href="blanket_help.html#accounting" target="help"><img src="info.gif" border=0 vspace=2 align=top></a></td> </tr> <tr> <td align=center> Billing Basis <input type=radio name=acct_method value=billing_basis> Cash Basis <input type=radio name=acct_method value=cash_basis><p> </td> <td> If station is brokered by another station <br> enter calls: <input type=text name=broker1 size=8 maxlength=4 onChange=validate_station(this)> - <input type=text name=broker2 size=3 maxlength=2 onChange=validate_station_type(this)><p> </td> </tr> <tr> <td align=center colspan=2> If all revenue to be reported by broker <input type=submit name=form_action value="Submit above information"> </td> </tr> </table> <p> <table border="0" width=640> <tr> <th colspan="2" align="center" bgcolor="#fff07b">Gross Revenue Up to $150,000</th> </tr> <tr> <td><a href="blanket_help.html#gross" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 1. Gross Revenue (excluding non-cash payments in goods and/or services)</td> <td><input type="text" size="20" name="line1" onChange=validate_dollars(this)></td> </tr> </table> <p> <STRONG>Please note: stations with gross revenue up to $150,000 cannot itemize their deductions.</strong> <p> <input type=submit name=form_action value="Submit form for revenue up to $150,000"> <p> <hr> <p> <table border="0" width=640> <tr> <th colspan="2" align="center" bgcolor="#fff07b">Gross Revenue Over $150,000</th> </tr> <tr> <td><a href="blanket_help.html#gross" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 3. Gross Revenue (excluding non-cash payments in goods and/or services)</td> <td><input type="text" size="20" name="line3" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#AGENCY_COMMIS" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 4. Advertising Agency Commissions</td> <td><input type="text" size="20" name="line4" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#POLITICAL" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 5. Revenue for Political Broadcasts</td> <td><input type="text" size="20" name="line5" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#LESS_AGCYCOMM" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 6. Less: Agcy. Comm included in 4 above</td> <td><input type="text" size="20" name="line6" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#BAD_DEBTS" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 8. Bad Debts</td> <td><input type="text" size="20" name="line8" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#BAD_RECOVERIES" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 9. Less: Bad Debt Recoveries</td> <td><input type="text" size="20" name="line9" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#RATE_CARD" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 11. Rate Card Discounts</td> <td><input type="text" size="20" name="line11" onChange=validate_dollars(this)></td> </tr> </table> <p> <input type=submit name=form_action value="Submit form for revenue over $150,000 without itemized deductions"> <p> <hr> <table border=0 width=640> <tr> <th colspan=2 bgcolor="#fff07b">Complete Only If You Itemize Deductions</th> </tr> </table> <P> <table width=640 border=0> <tr> <td><a href="blanket_help.html#news_services" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 22. News service</td> <td><input type="text" size="20" name="line22" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#remote" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 23. Remote Pickups</td> <td><input type="text" size="20" name="line23" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#broadcast" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 24. Broadcast Rights</td> <td><input type="text" size="20" name="line24" onChange=validate_dollars(this)></td> </tr> <tr> <td><a href="blanket_help.html#other" target="help"><img src="info.gif" border=0 vspace=2 align=top></a> 25. Other. Specify License Paragraph <input type=text name=line25_special size=25></td> <td><input type="text" size="20" name="line25" onChange=validate_dollars(this)></td> </tr> </table> <p> <table border=0> <tr> <th>Names of Personnel <a href="blanket_help.html#deductible" target="help"><img src="info.gif" border=0 vspace=2 align=top></a></th> <th>Annual Compensation</th> </tr> <tr align=center> <td><input type=text name=person1 size=40></td> <td> $ <input type=text name=comp1 size=10 onChange=validate_dollars(this)></td> </tr> <tr align=center> <td><input type=text name=person2 size=40></td> <td> $ <input type=text name=comp2 size=10 onChange=validate_dollars(this)></td> </tr> <tr align=center> <td><input type=text name=person3 size=40></td> <td> $ <input type=text name=comp3 size=10 onChange=validate_dollars(this)></td> </tr> <tr align=center> <td><input type=text name=person4 size=40></td> <td> $ <input type=text name=comp4 size=10 onChange=validate_dollars(this)></td> </tr> <tr align=center> <td><input type=text name=person5 size=40></td> <td> $ <input type=text name=comp5 size=10 onChange=validate_dollars(this)></td> </tr> <tr align=center> <td><input type=text name=person6 size=40></td> <td> $ <input type=text name=comp6 size=10 onChange=validate_dollars(this)></td> </tr> <tr align=center> <td><input type=text name=person7 size=40></td> <td> $ <input type=text name=comp7 size=10 onChange=validate_dollars(this)></td> </tr> <tr align=center> <td><input type=text name=person8 size=40></td> <td> $ <input type=text name=comp8 size=10 onChange=validate_dollars(this)></td> </tr> </table> <input type=hidden name=num_personnel value=8> <p> <input type=submit name=form_action value="Continue to next form to add additional personnel"> <p> <hr> <p> <input type=submit name=form_action value="Submit form for revenue over $150,000 with itemized deductions"> <p> <input type=reset value="Clear Form"> </CENTER> <p> </form> <CENTER> <p> <A HREF="/maps/iconbar.map"><img border=0 width=471 height=67 align=top src="/images/iconbar.gif" ISMAP usemap="#navbar"></A> <P> <h6> <a href="http://www.ascap.com/ascap.html">ASCAP HOME</a> | <a href="http://www.ascap.com/press/news.html">ASCAP IN THE NEWS</a> | <a href="http://www.ascap.com/about/about.html">ABOUT ASCAP</a> | <a href="http://www.ascap.com/membership/membership.html">MEMBERSHIP</a> <BR> <a href="http://www.ascap.com/playback/playback.html">PLAYBACK MAGAZINE</a> | <a href="http://www.ascap.com/legislative/legislative.html">LEGISLATIVE MATTERS</a> | <a href="http://www.ascap.com/ace/disclaim.html">ASCAP'S ACE ON THE WEB</a> <P> </h6> </CENTER> <center> <h6> <p> <a href="http://www.ascap.com/search.html">SEARCH ASCAP</a> | <a href="http://www.ascap.com/siteguide.html">SITE GUIDE</a> <p> <address>Copyright © 1997-2000 ASCAP<br> http://www.ascap.com</address> </h6> </center> <MAP NAME="navbar"> <AREA SHAPE=RECT COORDS="0,0 67,66" HREF="http://www.ascap.com/ascap.html" alt="ASCAP Home Page"> <AREA SHAPE=RECT COORDS="68,0 136,66" HREF="http://www.ascap.com/press/news.html" alt="ASCAP In the News"> <AREA SHAPE=RECT COORDS="137,0 202,66" HREF="http://www.ascap.com/about/about.html" alt="About ASCAP"> <AREA SHAPE=RECT COORDS="203,0 269,66" HREF="http://www.ascap.com/membership/membership.html" alt="Membership"> <AREA SHAPE=RECT COORDS="270,0 334,65" HREF="http://www.ascap.com/playback/playback.html" alt="Playback Magazine"> <AREA SHAPE=RECT COORDS="335,0 398,65" HREF="http://www.ascap.com/legislative/legislative.html" alt="Legislation Matters"> <AREA SHAPE=RECT COORDS="399,0 467,67" HREF="http://www.ascap.com/ace/disclaim.html" alt="ASCAP's ACE on the Web"> </MAP> </body>