NAB POLITICAL ADVERTISEMENT FORMS (PB-16)

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NAB Form PB-17 CandidatesCANDIDATE CERTIFICATIONIn Order For Federal Candidates to Receive The Lowest UnitCharge During a Political Window, the Following Certificationis Required:I, _________________________________________________________________(name of federal candidate or authorized committee) hereby certify that the programmingto be broadcast (in whole or in part) pursuant to this agreement:□ does □ does notrefer to an opposing candidate (check applicable box). I further certify that for theprogramming that does refer to an opposing candidate:(check applicable box)□ the radio programming contains a personal audio statement by the candidate thatidentifies the candidate, the office being sought, and that the candidate hasapproved the broadcast.□ the television programming contains a clearly identifiable photograph or similarimage of the candidate for a duration of at least four seconds, and a simultaneouslydisplayed printed statement identifying the candidate, that the candidate approvedthe broadcast, and that the candidate and/or the candidate’s authorized committeepaid for the broadcast.______________________________________________________________________signature of candidate or authorized committee____________________________________________________________printed name___________________dateCopyright ©2011 by the National Association of Broadcasters. May Not Be Copied, Reproduced or Further Distributed.3
NAB Form PB-17 CandidatesAGREED UPON SCHEDULE(TO BE FILLED IN ONLY IF STATION DOES NOT ACCEPT ALL OFCANDIDATE’S REQUEST)BroadcastLengthTime of Day,Rotation orPackageDays Class Times perWeekNumberof WeeksTotal Charges:AFTER AIRING OF BROADCASTS:Attach invoices or Schedule Run Summary to this Form showing:(1) actual air time and charges for each spot;(2) the date(s), exact time(s) and reason(s) for Make-Good(s), if any; and(3) the amount of rebates given (identify exact date, time, class of broadcast and dollaramount for each rebate), if any.Note: Because the FCC requires that the political file contain the actualtimes the spots air, that information should be included in the file assoon as possible. If that information is only generated monthly, the fileshould include the name of a contact person who can provide the timesthat specific spots aired.Copyright ©2011 by the National Association of Broadcasters. May Not Be Copied, Reproduced or Further Distributed.4
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NAB POLITICAL ADVERTISEMENT FORMS (PB-16)

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