Federal Communications Commission - Obscene, Profane, and/or Indecent Material Complaint Form

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FCC Form 475B

Estimated Time Per Response: 15 minutes Approved by OMB 3060-0874
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Federal Communications Commission
Washington, DC 20554

FCC Form 475B

Obscene, Profane, and/or Indecent Material Complaint Form

In order to process your complaint, the Commission needs the information marked below with an asterisk (*). Information not marked with an asterisk (*), if available, is also helpful.

Consumer's Information:

*First Name:
Middle Initial:
*Last Name:
*Post Office Box Number:
*Street Address:
*Either Street Address OR Post Office Box is required
*Zip Code:
*City:
*State:
E-Mail Address:
Daytime Telephone Number:	() - Extension:

*(1) Date of Program (use MM/DD/YYYY format):
*(2) Time of Program (use HH:MM AM/PM format):
*(3) Network:
*(4) Call Sign, Channel OR Frequency of the station on which you viewed/heard the material:
*(5) City and State Where Program Was Viewed/Heard:
*(6) Name of Program or DJ/Personality/Song/Film:

* Please include below as many details about the program as possible in order to help the FCC determine whether the material was obscene, profane, and/or indecent (such as specific words, language, images, etc.).

You are not required to submit a transcript or an audiotape, videotape, CD/DVD or other recording in support of your complaint. Doing so, however, may help expedite the processing of your complaint. If you choose to submit a transcript you should send both this complaint and the transcript to The Federal Communications Commission, Consumer & Governmental Affairs Bureau, Consumer Inquiries and Complaints Division, 445 12th Street, SW, Washington, DC 20554. If you choose to submit an audiotape, videotape, CD/DVD or other recording, you should send both this complaint form and the recording to Federal Communications Commission, Consumer & Governmental Affairs Bureau, Consumer Inquiries and Complaints Division, 9300 East Hampton Drive, Capitol Heights, Maryland 20743. Any documentation of the programming becomes part of the Commission's records and cannot be returned.

For additional information, please see our Obscene, Profane, and Indecent Broadcasts Fact Sheet at http://www.fcc.gov/cgb/consumerfacts/obscene.pdf.

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Federal Communications Commission
445 12th Street SW
Washington, DC 20554
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01.00.01 April 12, 2011