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STATE OF SOUTH CAROLINA SECRETARY OF STATE

NOTICE OF CHANGE OF FRANCHISE FEE RATE
Pursuant to state law, a person or entity seeking to provide cable or video service must have a certificate of franchise authority, either an existing certificate issued by a local government under prior law, or upon expiration of that certificate issued by a local government, a state-issued certificate of franchise authority issued by the Secretary of State under S.C. Code of Laws §58-12-310(B).
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Pursuant to Section 58-12-330(C) of the 1976 South Carolina Code of Laws, as amended, the below-named municipality or county hereby provides notice to the Secretary of State of the following change to its cable or video service franchise fee rate. No such change shall be effective as to the holder of a State-issued Certificate of Franchise Authority earlier than forty-five (45) days after the Secretary of State provides the holder written notice of change. 1. Municipality or County:

2.

Current cable or video service franchise fee rate:

3.

Proposed cable or video service franchise fee rate:

4.

Current holder(s) of State-Issued Certificates of Franchise Authority providing service in this municipality or county:
Provider Name and Title Address and Telephone No.

Date
Signature

______________________________________
Type or Print Name and Title

______________________________________
Address _______________________

_______ Telephone Number

NOTICE OF CHANGE OF FRANCHISE FEE RATE

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Form Revised by South Carolina Secretary of State June 2008

FILING INSTRUCTIONS
1. Two copies of this form, the original and either a duplicate original or conformed copy, must be filed with the Secretary of State. If the space in this form is insufficient, please attach additional sheets containing a reference to the appropriate paragraph in this form.

2.

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Return to:

South Carolina Secretary of State Attn: Wendy B. Holcombe Post Office Box 11350 Columbia, SC 29211

SPECIAL NOTES PURSUANT TO STATE LAW, A PERSON OR ENTITY SEEKING TO PROVIDE CABLE OR VIDEO SERVICE MUST HAVE A CERTIFICATE OF FRANCHISE AUTHORITY, EITHER AN EXISTING CERTIFICATE ISSUED BY A LOCAL GOVERNMENT UNDER PRIOR LAW, OR UPON EXPIRATION OF THAT CERTIFICATE ISSUED BY A LOCAL GOVERNMENT, A STATE-ISSUED CERTIFICATE OF FRANCHISE AUTHORITY ISSUED BY THE SECRETARY OF STATE UNDER S.C. CODE OF LAWS §58-12-310(B).