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AGREEMENT FORM FOR NON-CANDIDATE/ISSUE ADVERTISEMENTS: Station and Location: Date: |, Michelle Santuoso ‘do hereby request lation time concerning the flowing issue | Americans for Job Secunty ‘Time of Day, Broadcast | Rotation cr Days | Ges | Timea per Number Lange Package Week of Weeks Yotal Charges: “This broadcast ima will oe used by: _Amesicans For Jab Security Does the programming (in whole or in part) communicate “a message foiating fo any. political matier of national importance?" Oo LI Ne Coop D2 Soe ore ye Be Cane, Fm DE Forprogamming that “communicates 2 message relating to ary politcal matter of nati inmportance,” lis the name ofthe legally qualifed candidates} he programming refers to, the offcals} belng soup and the date(s) ofthe election(s (if applcable): For programming tat. "communicates a message alain to ary potitcal matter of national Imperianee, atach Agreed Upon Schedule Page 3) | representthat the payment forthe above described beosdeast time nas oeen fished by: ‘Americans For Jab Security 407 South West Street, PMB 591 Alexandria VA 22314 ‘Sten'ien DeMeura, Pres ‘and you are aUlVorzed Wo anrOun Pre Tie as pad Tor by auch pereen Grentily. Tre eniiy fumishing ‘te payment, ote thar an Individual pe'son is: Ci acomoration: [Jp commitee [ x jan association; LI or other unincorporated grows. ‘The names, offces. and adresses of the chierexscutve offices, ditectrs, andor authorizes fagerts of the antty ate named below (ray be atiached separately} THIS STATION DOESNOT DISCRIMINATE OR PERMIT DISCRIMINATION ON THE BASIS. OF RAGE OR ETHNICITY IN THE PLACMENT OF ADVERTISING. | agie to indermify and hold Harmless the sialon for any damages or liability, including reasonable atomey's fees, that ray engue fromthe brosccast ofthe above-requasted advertisemant(s), For the aoave-stated broadcasts} else agree fo prepare a script, transcript, oF tapa, which will be delivered the sialon at east = ‘beforathe time of the scheduled broadcasts, Y ISSUE ADVERTISER 703-672-0801 TO BE Sif eign? Dae 2 Gontak Prone Nombar TO BE SIGNED BY STATION REPRESENTATIVE OF Accepted CO rccepted in Par DD Rejected Sante ama Wem Te nig iy Done amen metas May Mae Copa Roper eam Deve AGREED UPON SCHEDULE Far All Issue Advertisements That Communicate a Message Relating to Any Political Matter of National Impcrtance Broadeset_ | Time of Day, ongth | Rotation or | Days Chass Times por | Number Package Week | of Wooks Total Charges: AFTER AIRING OF BROADCASTS: Attach invoices or Schedule Run Summary to this Form showing: {1)actual airtime and charges for each spot, {2)the date(s), exact time(s) ard reason(s) for Make-Goodis), if any; and {3)the amount of rebates given (identify exact date tine, class of broadcast and dollar amount far each rebate}, it any. Note: Becausethe FCC requires that the political file contain the actual times the spots air, that informatian should be included in the file as soon a possible. If that Informationis only generated monthly, the file should Include the name of a contact person who can provide the times that specific spots aired. ova 20 eR Astin aces oy re ee, a Fn Care,