( Column B County Name)
(CLEAR) CLEAR
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column B County Name)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column C Calendar year 2012 Cable and Video Service Franchise Fee Payments)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column D Contract Commencement Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column E Contract Termination Date)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Column F Franchisee Name)
(Company Name)
(PRINT) PRINT
(Row 1 Column A County Number)
(Row 10 Column A County Number)
(Row 11 Column A County Number)
(Row 12 Column A County Number)
(Row 13 Column A County Number)
(Row 14 Column A County Number)
(Row 15 Column A County Number)
(Row 16 Column A County Number)
(Row 17 Column A County Number)
(Row 18 Column A County Number)
(Row 19 Column A County Number)
(Row 2 Column A County Number)
(Row 20 Column A County Number)
(Row 3 Column A County Number)
(Row 4 Column A County Number)
(Row 5 Column A County NumberRow )
(Row 6 Column A County Number)
(Row 7 Column A County Number)
(Row 8 Column A County Number)
(Row 9 Column A County Number)
(SBE NO )
ACOUNTY NUMBERBCOUNTY NAMECCALENDAR YEAR 2012CABLE AND VIDEO SERVICE
BOE 517 FF (FRONT) REV 5 (12 12)
COMPANY NAME
FRANCHISE FEE PAYMENTSDCONTRACTCOMMENCEMENTDATEECONTRACTTERMINATIONDATEFFRANCHISE NAME
Please read instructions on reverse before preparing this schedule
SBE NO
SCHEDULE OF FRANCHISE FEE PAYMENTSBOARD OF EQUALIZATION
STATE OF CALIFORNIA