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1. TV Provider (Select one):
 Charter Satellite FIOS U-Verse Antenna

2. Internet Provider (Select one):
 Charter Verizon/FIOS ATT/U-Verse No Internet

3. Home Phone Provider (Select one):
 Charter Verizon/FIOS ATT/U-Verse No Home Phone

4. Do you subscribe to a Hispanic TV Package? (Select one):
 Yes No

5. Do you call Mexico? (Select one):
 Yes No

6. May we call you with special offers? (Select one):
 Yes No

NO PURCHASE NECESSARY. A PURCHASE WILL NOT INCREASE YOUR CHANCE OF WINNING. This Sweepstakes is open only to legal residents of
the contiguous United States except New York, who reside in a Charter Communications serviceable area, and who are 18 years of age or older and
the age of majority in the jurisdiction they reside at the time of entry. Sweepstakes begins 5:00 p.m. PT 10/4/13 and ends 10/6/13 10:00 p.m. PT.
For complete details see Official Rules from available from 14600 Trinity Blvd., Suite 100, Fort Worth TX 76155. Sponsor: Charter Communications
Operating, LLC. VOID WHERE PROHIBITED OR RESTRICTED BY LAW. 0913 D253