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"J-COG <br />S. Status of Previous Filing of FCC Form 1210 (enter an "z" hr the appropriate boz) <br />CATV Re ulation <br />as <br />YES NO <br />a. Has an FCC Form 1210 been previously Sled with the FCCT z <br />If yes, enter the date of the most recent filing: (mm/ddlyy) <br />YES NO <br />b. Has an FCC Form 1210 been previously filed with the Franchising Authority? z <br />If yes, enter the date of the most recent Sling: 05125]1994 (mm/dd/yy) <br />9. Status of FCC Form 1200 Fitlng (enter an "z" in the appropriate boz) <br />YES NO <br />a_ Has an FCC Form 1200 been previously Slod with the FCC? z <br />If yes, euUer the date Sled: (mm/dd/yy) <br />YES NO <br />b. Has an FCC Form 1200 been previously Sled with the Franchising Autharity7 X <br />Ifyes, enter the date Sled: ~~ (mm/dd/yy) <br />10. Cable Pr+ogramrrdstg 3er~lces Comphrhrt Status (enter an ":" in the appropriate boz) <br />YES NO <br />a. Ia this tam being Sled in response in an FCC Font 329 comphtint7 z <br />If yes, eritrr the date of the complaint (mm/ddlyy) <br />YES xo <br />il. is FCC Form 1205 Belrrg lrtrllotded With This Filing <br />12. Sdectlon of "Going Forward" Charmd Addition Metlrodolo® (enter an "z" ha the appropriate boz) <br />Check here if you are using fire original rules [MARKUP METHOD]. 20001vIPR=S 10.57 <br />Check here if you are using the new, alive rules [CAPS METHOD]. 2001 MPR=$11.92 <br />if using the CAPS METHOD, havo you elected ~ revise recovery far 2002 MPR=$11.70 <br />cT>anoels added doting tlx period May 1 s, 1994 to Dec. 31, 199x? <br />i3. Headertd Upgrade Mefhodolo® <br />'NOTE: Operators mrut rxrlijy to the Conmdssion tlatireligrbiltty to use thin rpgrade metlwdology and attach an equipmem list and depreciation schednlen <br />Check bete if you are a qualifying small system using the sheamlined headend upgrade methodology. <br />Part I: Preliminary Information <br />Module A: Marimum Permitted Rate From Previous Filing <br />c d e <br />13oe IJae ~ Baric Tkr 2 liar 3 Tier 4 Tier 3 <br />Al Ctataat Maximum Pemtitted Rate ti11.9189 <br />Module B: Subscn'berslup <br />a b e d e <br />r ~.. r a. rr...~.r~.... nor.. Tier 2 Tier 3 lies 4 Tin S <br />Bi Average Subxaibersbip Fa Tru~Up period I 30 <br />B2 Average Sulasca~aahip Fa True-Up period 2 <br />B3 Estimated Average Subaen'baslrip For projected period 30 <br />Module C: Inflation Information <br />Page 1 FCC Form 1240, July 1996 <br />