INSTRUCTIONS FOR FCC FORM 2100 APPLICATION FOR MEDIA

Federal Communications Commission Approved by OMB

Washington, D.C. 20554 3060-0027

INSTRUCTIONS FOR FCC FORM 2100

APPLICATION FOR MEDIA BUREAU

VIDEO SERVICE AUTHORIZATION

GENERAL

INSTRUCTIONS

A. We have estimated that each response to this collection of

information will take on average 3.5 hours for different

Schedules attached to this form. Our estimate includes the

time to read the instructions, look through existing

records, gather and maintain required data, and actually

complete and review the form or response. If you have

any comments on this estimate, or on how we can

improve the collection and reduce the burden it causes

you, please write the Federal Communications

Commission, AMD-PER

M, Washington, DC 20554,

Paperwork Reduction Project (3060-0798). We

w

il

l also

accept your comments via the Internet at PRA@fcc

.gov.

Please do not send completed application forms to this

address.

You are not required to respond to a collection of

information sponsored by the Federal government, and

the government may not c

onduct

or sponsor this

collection unless it displays a currently valid OMB

control number with this notice.

This notice is required by the Privacy Act of 1974, Public

Law 93-579, December 31, 1974, 5 U.S.C. § 552a(e)(3)

and the Paperwork Reduction Act of 1995, Public Law

104-13, October 1, 1995, 44 U.S.C. 3507.

B. Purpose of Form. FCC Form 2100 is a multi-purpose

form. It is used to apply for authority to construct a new

commercial TV broadcast station, for a new or a

modification of an existing broadcast station license, and

to perform a variety of other miscellaneous transactions

in the M edia Bureau (

M

B).

The purpose of this form is to collect data pertaining

to the proposed request. This data is used by the FCC

to determine whether the public interest would be

served by a grant of the request.

C. Introduction. FCC Form 2100 is a multi-part form

comprising a Main Form and several optional schedules.

Each application, amendment, modification, or other

request must contain only one Main Form but may

contain as few or as many of the optional schedules as

necessary.

D. Main F

orm. The Main Form contains questions and

certifications applicable to all FCC Form 2100 filers. The

Main Form is required for every application filed on

FCC Form 2100, including Modifications and

Amendments.

E.

Schedules

The purposes of the optional schedules are as follows:

(1) Schedule A

The Schedule to app

ly for authority to construct a

new commercial TV broadcast station or to make

changes in the existing facilities of such a station. In

the case of new station and major modification

proposals, this Schedule is filed by either the

successful bidder at a broadcast frequency auction or

by an applicant proposing facilities that are not

mutually exclusive with any other application filed

during the same window and thus not subject to

the Commission's c

ompar

ative bidding procedures.

All proposals for minor changes to authorized

commercial stations are also to be filed using this

Schedule. Approved by OMB control number:

3060-0027.

(2) Schedule B

The Schedule for applying for a new or modified

noncommercial educational or commercial digital

television (DTV) broadcast license. The Schedule

All previous editions obsolete. FCC 2100

Instructions

May

2015

may be used to cover an authori

zed construction

permit (or auxiliary antenna), provided that the

facilities have been constructed in compliance with

the provisions and conditions specified on the

construction permit and to implement modifications

to existing licenses as permitted by 47 C.F.R. §§

73.1675(c), 73.1690(e). Approved by OMB control

number:

3060-0837.

(3) Schedule C

The Schedule to apply for authority to construct a new

low power or television Translator station or make

changes in the existing facilities of such stations. All

Proposals for minor changes to authorized LPTV or

TV translator stations are also to be filed using this

Schedule. Approved by OMB control number: 3060-

0016.

(4) Schedule D

The Schedule to apply for a new low power or

television translator station broadcast license. The

Schedule may be used to cover an authorized

construction permit , provided that the facilities have

been constructed in compliance with the provisions

and conditions specified on the construction permit.

Approved by OMB control number: 3060-0837.

(5) Schedule E

The Schedule to apply for authority to make changes

in in the existing facilities of Class A stations.

Approved by OMB control number: 3060-0932.

(6) Schedule F

The Schedule to apply for a new class A station

broadcast license. The Schedule may be used to cover

an authorized construction permit, provided that the

facilities have been constructed in compliance with the

provisions specified on the construction permit. This

Schedule also may be filed to convert an exiting or

licensed LPTV station authorization to class A status.

Approved by OMB control number: 3060-0928.

F.

Schedules

Required

Applicable Schedules Required for TV Broadcast

Stations

Service

Licensing

Modernization

Form/Schedule

Title

TV

Broadcast

Stations

FCC 2100 Main Form – Application for Media

Bureau Audio and Video Service Authorization

Schedule A

– Schedule for a Construction Permit

for a Commercial Broadcast Station Approved by

OMB: 3060

-0027

TV

Broadcast

Stations

FCC 2100 Main Form – Application for Media Bureau

Audio and Video Service Authorization Schedule A

–

Schedule for a Digital Television Broadcast Station

License Approved by OMB: 3060

-0837

LPTV / TV

Translator

Broadcast

Stations

FCC 2100 Main Form – Application for Media

Bureau Audio and Video Service Authorization

Schedule C

– Schedule for a Construction Permit

for a LPTV or TV Translator Broadcast Station

Approved by OMB: 3060

-0016

LPTV / TV

Translator

Broadcast

Stations

FCC 2100 Main Form – Application for Media

Bureau Audio and Video Service Authorization

Schedule D

– Schedule for a LPTV / TV Translator

Broadcast Station License Approved by OMB:

3060

-0837

Class A TV

Broadcast

Stations

FCC 2100 Main Form – Application for Media

Bureau Audio and Video Service Authorization

Schedule E

– Schedule for a Construction Permit

for a Class A Broadcast Station Approved by

OMB: 3060

-0932

Class A TV

Broadcast

Stations

FCC 2100 Main Form – Application for Media

Bureau Audio and Video Service Authorization

Schedule F

– Schedule for a Class A Broadcast

Station License Approved by OMB: 3060

-0928

TV / Class A

TV Broadcast

Stations

FCC 2100 Main Form – Application for Media

Bureau Audio and Video Service

Authorization

Schedule 381

– Certification of TV Broadcast

Licensee Technical Information in Advance of

Incentive Auction Approved by OMB: 3060

-

1206

GENERAL FILING

INSTRUCTIONS

A.

Provide All Information Requested:

Applicants should provide all information requested by the

application. If any portion of an application is not

applicable, the applicant should so state. Defective or

incomplete applications will be returned without

consideration. Inadvertently accepted applications are

also subject to dismissal. See 47 C.F.R. § 73.3564(b).

B.

Information Current and Complete:

Information filed with the FCC must be kept current

and complete. The Applicant must notify the FCC

regarding any substantial and significant changes in the

information furnished in the application(s). See 47

C.F.R. § 1.

65.

C. Applicable Rules and Regulations:

Applicants should obtain the relevant parts of the FCC’s

rules in Title 47 of the Code of Federal Regulations. Copies

of Title 47 may be purchased from the Superintendent o f

Documents; Government Printing Office; Washington, DC

20402; (202) 512- 1800. Refer also to the Government

Printing Office’s website at http://www.access.gpo.gov.

Some FCC rules require the Applicant to attach one or more

exhibits to an application in addition t o the information

requested in the application form.

INSTRUCTIONS FOR SECTION I: GENERAL

INFORMATION

Upon grant of a license application, the Licensee may be

subject to certain construction or coverage requirements.

Failure to meet the construction or coverage requirements

may result in termination of the license. Consult

appropriate FCC regulations to determine the

construction or coverage requirements that apply to the

type of license requested in this application.

A. Electronic Filing

FCC Form 2100 must be filed

electronically.

B. Exhibits

Each document required to be filed as an exhibit

should be current as of the date of filing. Each page of

every exhibit must be identified with the number or

letter of the exhibit, the number of the page of the

exhibit, and the total number of pages of the exhibit.

If material is to be incorporated by reference, see the

instruction on incorporation by reference. If

interference studies are required by rule, attach these

as an exhibit.

C.

Incorporation

by Reference

You may incor

porate by reference documents, exhibits,

or other lengthy showings already on file with the FCC

only if the information previously filed is more than

one 8½” by 11” page in length, and all information

therein is current and accurate in all significant

respects; the reference states specifically where the

previously filed information can be found (i.e., station

call sign and application file number, title of proceeding,

docket number and legal citations), including exhibit

and page references. Use

the r

elevant item

number followed by ‘A’. Items that call for numbers,

or which can be answered ‘Y’ or ‘N’ or other

short answers must be answered directly without

reference to a previous filing.

D. Station Public Inspection File

A copy of

t

h

e

c

o m

p

l

e

t

e

d

a

p p lic

a

tio

n and all

related documents shall be made available for inspection

by the public

in the station’s public inspection file pursuant to 47 C.F.R.

§73.3526 for commercial stations and 47 C.F.R.§

73.3527 for noncommercial educational stations.

E.

Certifying

Compliance

This app

lication requires applicants to certify

compliance with many statutory and regulatory

requirements. Each response contained within the

application constitutes a certification. Furthermore, each

applicant is responsible for the information that the

application instructions and worksheets convey. As a

key element in the Commission's streamlined licensing

process, a certification that these materials have been

reviewed and that each question response is based on the

applicant's review

is required.

F. Detail

ed instructions and worksheets provide additional

information regarding Commission rules and policies.

These materials are designed to track the standards and

criteria that the Commission applies to determine compliance

and to increase the reliability of applicant certifications.

They are not intended to be a substitute for familiarity with

the Communications Act and the Commission's regulations,

policies, and precedent. Each applicant is responsible for the

information that the applicati

on instructi

ons and worksheets

convey. Applicants are required to review all application

instructions and worksheets.

G. This app

lication is presented primarily in a "Yes/No"

certification format. However, it contains places for

submitting explanations and exhibits where necessary or

appropriate. Each certification constitutes a material

representation. Applicants may only mark the "Yes"

certification when they are certain that the response is correct.

A "No" response is required if the applicant is requesting a

waiver of a pertinent rule and/or policy, or where the

applicant is uncertain that the application fully

satisfies the

perti

nent rule and/or policy. Thus, a "No" response to any of

the certification items will not cause the immediate dismissal

of the application provided that an

appropriate

exhibit is

submitted.

H. Authorization to Sign the Application

The applicant and the applicant's authorized representative,

if any, must sign the app

lication. Depending on the nature of

the applicant, the application should be signed as

follows: if a sole proprietorship, personally; if a partnership,

by a general partner; if a corporation, by an officer; for an

unincorporated association, by a member who is an officer; if

a governmental entity, by such duly elected or appointed

official as is competent under the laws of the particular

jurisdiction. Counsel may sign the application for

his or

her cli

ent, but only in cases of the applicant's disability or

absence from the United States. See 47 C.F.R. §

73.3513. The signature of an electronically filed

application consist of the electronic equivalent of the typed

name of the individual. See Report and Order in MM Docket

No. 98-43, 13 FCC Rcd 23056, 23064 (1998).

I. FCC

Registration

Number (FRN)

To comply with the Debt Collection Improvement Act of

1996, the applicant must enter its FRN number, a ten-digit

unique entity identifier for anyone doing business with the

Commission. The FRN can be obtained through the FCC

webpage at http://www.fcc.gov or by manually submitting

FCC Form 160. FCC Form 160 is available for downloading

from http://www fcc.gov/formpage. html or by calling 1-

800-418-3676. Questions concerning the FCC Registration

Number can be directed to the Commission’s Registration

System help desk at

http://www.CORES@fcc.gov

or by

calling 1-877-480-3201. Facility ID Number. Radio and

TV Facility ID Numbers can be obtained at the FCC's

Internet Website at

www.fcc.gov/mb. Once at this website,

scroll down and select CDBS Public Access. You can

also obtain your Facility ID Number by calling: Radio (202)

418-2700, TV (202) 418-1600. Further, the Facility ID

Number is now included on all Radio and TV authorizations

and postcards.

For Assistance

For assistance with this application, contact the

Federal Communications Commission, 1270 Fairfield

Road, Gettysburg, PA 17325-7245, call (877) 480-3201

(TTY 717-338-2824), or visit http://esupport.fcc.gov.

INSTRUCTIONS

FOR FCC 2100 MAIN FORM

A. Fees, Waivers, and Exemptions

The Commission is statutorily required to collect charges for

certain regulatory services to the public.

Applications requiring a fee, as well as the corresponding

fee, are listed in the "Media Bureau Fee Filing Guide,"

which can be found on the Commission’s website,

www.fcc.gov.

Government entities, however, are

exempt from this fee requirement. Exempt entities

include possessions, states, cities, counties, towns, villages,

municipal organizations, and political organizations or

subparts thereof governed by elected or appointed

officials exercising sovereign direction over

communities or governmental programs. Also exempt are

full- service noncommercial educational radio and TV

broadcast license

es

a

n

d

permittees

, provided that the

proposed facility will be operated noncommercially. See

47 C.F.R. § 1.1116.

When filing a fee-exempt application, an applicant must

indicate the reason for the fee exemption and provide an

explanation

as appropriate.

Applicants have the option of paying by credit card or

by FCC Form 159 when submitting the application.

For further information regarding the applicability of a fee,

the amount of the fee, or the payment of the fee; applicants

should consult the "Media Bureau Fee Filing Guide,"

which can be found on Commission’s website,

www.fcc.gov.

B.

Applicant

Information

Applicant Name, Type, and Contact Information: The

name of the applicant must be stated exactly. If the

applicant is a corporation, the exact corporate name; if a

partnership, the name under which the partnership does

business; if an unincorporated association, the name of an

executive officer, his/her office, and the name of the

association; and, if an individual applicant, the person's

full legal name. Applicants should use only those state

abbreviations approved by the U.S. Postal Service.

C. Contact Representatives. If the applicant is represented

by a third party (for example, legal counsel), that person's

name, firm or company, mailing address and

telephone/electronic mail address must be specified.

D. Alien Ownership. All applications must comply with

Section 310 of the Communications Act, as amended.

Specifically, Section 310 proscribes the

ho

ld

ing

a

nd

transfer

o

f a broadcast construction permit or station

license to an alien, a representative of an alien, a foreign

government or the representative thereof, or a corporation

organized under the laws of a foreign government. This

proscription also applies with respect to any entity of which

more than 20% of the capital stock is owned or voted by

aliens, their representatives, a foreign government or its

representative, or an entity organized under the laws of a

foreign country. The Commission may also deny a

broadcast construction permit or station license to a licensee

directly or indirectly controlled by another entity of which

more than 25% of the capital stock is owned or voted by

aliens, their representatives, a foreign government or its

representative, or another entity organized under the laws of

a foreign country.

Compliance with section 310 is determined by means of a

two-prong analysis, one pertaining to voting interests and

the second to ownership interests. See, e.g., BBC License

Subsidiary L.P., 10 FCC Rcd 10968 (1995). The voting

interests held by aliens in a licensee through intervening

domestically organized entities are determined in

accordance with the multiplier guidelines for calculating

indirect ownership interests in an applicant as set forth in

the "Corporate Applicant" Instructions . For example, if

an alien held a 30% voting

interest in Corporation A which,

in turn, held a non- controlling 40 % voting interest in

Licensee Corporation B, the alien interest in Licensee

Corporation B would be calculated by multiplying the

alien's interest in Corporation A by that entity's voting

interest in Licensee Corporation B. The resulting voting

interest (30% x 40% = 12%) would not exceed the 25%

statutory benchmark. However, if Corporation A held a

controlling 60% voting interest in Corporation B, the

multiplier would not be utilized and the full 30 percent

alien v

oting interest in Corporation A would be treated as a

30 % interest in Licensee Corporation B, i.e., an

impermissible 30% indirect alien voting interest in the

licensee. If Partnership A held a 40% voting interest in

Licensee Corporation B, that voting interest would be

similarly impermissible if any general partner or any non-

insulated limited partner of partnership A was an alien,

regardless of his or her

partnership

interest.

Applicants must also comply with the separate alien

equity ownership benchmark restrictions of Section 310.

Under the second prong of the analysis, an applicant must

determine the pro rata equity holdings of any alien investor

in a licensee entity or its parent. In calculating alien

ownership, the same voting interest multiplier rules apply.

In order to complete this two-prong analysis, an

applicant must determine the citizenship of each entity

holding either a voting or equity interest or explain how it

determined the relevant percentages. Corporate applicants

and licensees whose stock is publicly traded have

employed a variety of practices, including sample surveys

using a recognized statistical methodology, a separate

restrictive class of stock for alien owners, and the

compiling of citizenship informati

on on each stockholder

by the corporation's stock transfer agent, to ensure the

accuracy and completeness of their citizenship disclosures

and their continuing compliance with Section 310.

Finally, Applicants are directed to review the policies

and clarifications set forth in

Commission Policies

and Procedures Under Section 310(b)(4) of the

Communications Act, Foreign Investment in Broadcast

Licensees, Declaratory Ruling, MB Docket No. 13-50,

28 FCC Rcd. 16244 (2013).

E. Parties to the Application. This section requires the

disclosure of information on the applicant and all parties

to the application. As used in this application form, the

term "party to the application" includes any individual or

entity whose ownership or positional interest in the

applicant is attributable. An attributable interest is

an ownership interest in or relation to an applicant or

licensee, which will confer on its holder that degree of

influence or control over the applicant or licensee

sufficient to implicate the Commission's multiple

o

wnership rules. In responding, applicants should

review the Commission's multiple ownership attribution

policies and standards which are set forth in the Notes

to 47 C.F.R. §73.3555, as revised pursuant to Report and

Order in MB Dockets 02- 277 and 03-130, and MM

Dockets 01-235, 01-317, and 00- 244, 18 FCC Rcd

13620 (2003), aff’d in part and remanded in part,

Prometheus Radio Project, et al. v. F.C.C., 373 F.3d

372 (3d Cir. 2004), stay modified, No. 03-3388 (Sept. 3,

2004), and/or as revised in Review of the Commission's

Regulations Governing Attributi

on of Broadcast and

Cable/MDS Interests, 14 FCC Rcd 12559 (1999),

reconsideration granted in part, 16 FCC Rcd 1097

(2000) 2006 Quadrennial Regulatory Review-

Review of the Commission’s Broadcast Ownership

Rules and Other Rules Adopted Pursuant to Section 202

of the Telecommunications Act of 1996, Report and

Order and Order on Reconsideration, MB Docket No. 06-

121 et al., 23 FCC Rcd 2010 (2008) (“2006

Quadrennial Media Ownership Order”).

Generally, insulated limited partners or members of a limited

liability corporation, certain investors, and certain creditors

are not considered parties to the application. However, as set

forth in Worksheet #2E entitled, "Investor Insulation and

Non-Party Influence over Applicant," the holder of such an

interest may be deemed a party to the application and, if so,

must be listed. In the event that the Investor Insulation and

Non- Party Influence over Applicant worksheet requires

the submission of an explanatory exh

ibit, the applicant must

respond "No" to the Equity and Financial Interest

certification located in the Attributable Interest Section

of the application and complete this exhibit.

F. Equity/Debt Plus Attribution Standard. Certain

interests held by substantial investors in, or creditors of, the

applicant may also be attributable and the investor

reportable as a party to the application, if the interest falls

within the Commission's equity/debt plus (EDP) attribution

standard. Under the EDP standard, the interest held is

attributable if, aggregating both equity and debt, it exceeds

33 percent of the total asset value (all equity plus all debt) of

the applicant – a broadcast station licensee, cable television

system, daily newspaper or other media outlet subject to the

Commission’s broadcast multiple ownership or cross-

ownership rules – AND the interest holder also holds (1) an

attributable interest in a media outlet in the same market, or

(2) supplies over 15 percent of the total weekly broadcast

programming hours of the station in which the interest is

held. For example, the equ

ity interest of an insulated limited

partner in limited partnership applicant would normally not

be considered attributable, but, under the EDP standard, that

interest would be attributable if the limited partner’s interest

exceeded 33 percent of the applicant’s total asset value

AND the limited partner also held a 5 percent voting interest

in a radio or television station licensee in the same market.

The interest holder may, however, exceed the 33 percent

threshold without triggering attribution where such

investment would enable an eligible entity to acquire a

broadcast station provided that: (1) the combined equity and

debt of the interest holder in the eligible entity is less than

50 percent, or (2) the total debt of the interest holder in the

eligible entity does not exceed 80 percent of the asset value

of the station being acquired by the eligible entity and the

interest holder does not hold any equity interest, option, or

promise to acquire an equity interest in the eligible entity or

any related entity. See In re Promoting Diversification of

Ownership in the Broadcasting Services, Report and Order

and Third Further Notice of Proposed Rule Making, 23 FCC

Rcd 5922 (Mar. 5, 2008).

G. The Commission defines an “eligible entity” as any entity

that qualifies as a small business under the Small Business

Administration’s size standards for its industry grouping, as

set forth in 13C.F.R. §§ 121-201, and holds (1) 30 percent

or more of the stock or partnership interests and more

than 50 percent of the voting power of the corporation or

partnership that will own the media outlet; or (2) 15

percent or more of the stock or partnership interests and

more than 50 percent of the voting power of the

corporation or partnership that will own the media outlet,

provided that no other person or entity owns or controls

more than 25 percent of the outs

tanding stock or

partnership interests; or (3) more than 50 percent of the

voting power of the corporation that will own the media

outlet if such corporation is a publicly traded company.

In the event the Applicant claims status as an eligible

entity, the Applicant must submit an explanatory exhibit

demonstrating compliance. The Applicant

must retain and provide on request, material

documentation, including, for example, annual financial

statements or tax returns, etc., used to establish the basis

for the applicant’s response.

H. Additionally, "parties to the application" includes the

following with respect to each of the listed

applicant

entities:

Individual Applicant: The natural person seeking to

hold in his or her own right the authorization specified in

this application.

Partnership Applicant: Each partner, including all

limited partners. However, a limited partner in a limited

partnership is not considered a party to the application IF

the limited partner is not materially involved, directly or

indirectly, in the management or operation of the media

related activities of the partnership and the applicant so

certifies in response to the Equity and Financial Interest

certification. Sufficient insulation of a limited partner for

purposes of this certification would be assured if the

limited partnership a

rrangement:

(1) specifies that any exempt limited partner (if not a

natural person, its directors, officers, partners, etc.)

cannot act as an employee of the limited partnership

if his or her functions, directly or indirectly, relate to

the media enterprises of the company;

(2) bars any exempt limited partner from serving, in any

material capacity, as an independent contractor or

agent with respect to the partnership's media

enterprises;

(3) restricts any exempted limited partner from

communicating with the licensee or the general

partner on matters pertaining to the day-to-day

operations of its business;

(4) empowers the general partner to veto any admissions of

additional general partners admitted by vote of the

exempt limited partners;

(5) prohibits any exempt limited partner from voting on

the removal of a general partner or limits this right to

situations where the general partner is subject to

bankruptcy proceedings, as described in Sections

402 (4)-(5) of the Revised Uniform Limited

Partnership Act, is adjudicated incompetent by art of

competent jurisdiction, or is removed for cause, as

determined by an independent party;

(6) bars any exempt limited partner from performing any

services to the limited partnership materially relating

to its media activities, with the exception of making

loans to, or acting as a surety for, the business; and

(7) states, in express terms, that any exempt limited

partner is prohibited from becoming actively involved

in the management or operation of the media

businesses of the partnership.

Notwithstanding conformance of the partnership agreement

to these criteria, however, the requisite certification cannot

be made IF the limited partner’s interest is attributable

under the Commission’s EDP attribution standard

described below; or IF the applicant has actual knowledge

of a material involvement of a limited partner in the

management or operation of the media-related businesses

of the partnership. In the event that the applicant cannot

certify as to the noninvolvement

of a limited partner, the

limited partner will be considered as a party to this

application.

Limited Liability Applicant: The Commission treats an

LLC as a limited partnership, each of whose members is

considered to be a party to the application. However,

where an LLC member is insulated in the manner

specified above with respect to a limited partnership and

where the relevant state statute authorizing the LLC

permits an LLC member to insulate itself in accordance

with the Commission's criteria, that LLC member is not

considered a party to the application. In such a case, the

applicant should certify "Yes" in response to

the Equity

and Financial Interests Certification.

Corporate Applicant: Each officer, director and owner of

stock accounting for 5% or more of the issued and

outstanding voting stock of the applicant is considered a

party to the applicant. Where the 5% stock owner is itself a

corporation, each of its stockholders, directors and

"executive" officers (president, vice-president, secretary,

treasurer or their equivalents) is considered a party to this

application UNLESS the applicant submits as an exhibit a

statement establishing that an individual director or officer

will not exercise authority or influence in areas that will

affect the applicant or the station. In this statement, the

applicant should identify the individual by name and title,

describe the individual's duties and responsibilities, and

explain the manner in which such individual is insulated

from the corporate applicant and should not be attributed an

interest in the corporate applicant or considered a party to

this application. In addition, a person or entity holding an

ownership interest in the corporate stockholder

of the

applicant is considered a party to this

application

ONLY IF

that interest, when multiplied by the corporate stockholder's

interest in the applicant, would account for 5% or more of

the issued and outstanding voting stock of the applicant.

For example, where Corporation X owns stock accounting

for 25% of the applicant's votes, only Corporation X

shareholders holding 20 percent or more of the issued and

outstanding voting stock of Corporation X have a 5% or

more indirect interest in the applicant (.25 x

.20 = .05) and, therefore, are considered parties to this

application. In applying the multiplier in this context, any

entity holding more than 50% of its subsidiary will be

considered a 100% owner. Where the 5% stock owner is a

partnership, each general partner and any limited partner

that is noninsulated, regardless of the partnership interest,

is considered a party to the application.

Stock subject to stockholder cooperative voting agreements

accounting for 50% or more of the votes in a corporate

applicant will be treated as if held by a single entity and any

stockholder holding 5% or more of the stock in that block is

considered a party to this application.

An investment company, insurance company or trust

department of a bank is not considered a party to this

application, and an applicant may properly certify that such

entity's interest is non-attributable, IF its aggregated holding

accounts for less than 20% of the outstanding votes in the

applicant AND IF:

(1) such entity exercises no influence or control over

the corporation, directly or indirectly; and

(2) such entity has no representatives among the

officers and directors of the corporation.

And Other Applicant: Each executive officer, member

of the governing board and owner or holder of 5% or more

of the votes in the applicant is considered a party to the

applicant.

I. Equity and Financial Interests. Applicants are directed

to review compliance with the Commission’s broadcast

attribution rules and policies, as discussed in the

instructions to the Parties to the Application Section.

J. Multiple Ownership. These items require that the

applicant either certify compliance with, or request waiver of,

the Commission's broadcast ownership rules, including

restrictions on investor insulation and participation of non-

party investors and creditors. An Exhibit is required only if

requesting a waiver demonstrating compliance with 47

C.F.R. § 73.3555(a) or, if the applicant cannot certify

compliance, requesting a waiver or exemption, with adequate

justification. In order to facilitate the evaluation of the

transaction that is the subject of FCC Form 2100, applicants

are directed to Worksheet #2, which is tailored to the

individual inquiries.

K. Eligible Entities: The Commission defines an “eligible

entity” as any entity that qualifies as a small business under

the Small Business Administration’s size standards for its

industry grouping, as set forth in 13 C.F.R. §§ 121- 201,

and holds (1) 30 percent or more of the stock or partnership

interests and more than 50 percent of the voting power of

the corporation or partnership that will own the media

outlet; or (2) 15 percent or more of the stock or partnership

interests and more than 50 percent of the voting power of

t

he corporation or partnership that will own the media

outlet, provided that no other person or entity owns or

controls more than 25 percent of the outstanding stock or

partnership interests; or (3) more than 50 percent of the

voting power of the corporation that will own the media

outlet if such corporation is a publicly traded company.

In the event the Applicant claims status as an eligible entity,

the Applicant must select "Yes" to the Multiple Ownership

Question and submit an explanatory exhibit demonstrating

compliance. The Applicant must retain and provide on

request, material documentation, including, for example,

annual financial statements or tax returns, etc., used to

establish the basis for the applicant's response.

INSTRUCTIONS FOR SCHEDULE A - SCHEDULE FOR

CONSTRUCTION PERMIT FOR A COMMERCIAL

BROADCAST STATION

GENERAL APPLICATION

INSTRUCTIONS

A. Financial Qualifications. Applicants are not required to

certify as to their financial qualifications in Schedule A.

See Implementation of Section 309(j) of the

Communications Act -- Competitive Bidding for

Commercial Broadcast and Instructional Fixed Service

Licenses, 13 FCC Rcd 15920, 15989 (1998) ("Auctions

Order"). Nevertheless, the Commission's substantive

financial qualification requirements are unchanged. All

applicants for new broadcast facilities must have reasonable

assuran

ce of committed financing sufficient to construct

the proposed facility and operate it for three months

without revenue at the time they file Schedule A. See

Merrimack Valley Broadcasting, Inc., 82 FCC 2d 166,

167 (1980); Liberty Productions, 7 FCC Rcd 7581, 7584

(1992).

B. Channel and Facility Information and Antenna

Location and Technical Data. The applicant must ensure

that the facility specifications are accurate. Conflicting data

found elsewhere in the application will be disregarded. All

items must be completed. The response "on file" is not

acceptable. The response "not applicable" is not acceptable

unless otherwise noted.

C. Notifications. All applicants must comply with the

requirements of Section 73.1030. Specifically, applicants

must notify United States Government radio astronomy

installations, radio receiving installations, and FCC

monitoring stations of the proposed facility and its possible

impact on their operations. The Commission need not

be informed of the date of such notification.

D. Antenna Structure Registration. For information when

an Antenna Structure Registration (“ASR”) number is

required and how to acquire an ASR number,

please review the information posted on the

Commission’s website at

http://www fcc.gov/category/help/wireless-

telecommunications-bureau/asr-overview.

E. Transmitter Make and Model. An indication as to the

specific transmitter make and model is not required by

Schedule A. Rather, any permit authorizing construction

will require installation of a type- accepted transmitter or

one complying with the provisions of 47 C.F.R. Section

73.1660.

F. Coordinates. Applicant should use NAD 83 for the

geographic coordinates of the transmitter site in their

applications.

CONSTRUCTION

PERMIT CERTIFICATIONS

A . Environmental Effects. The National Environmental

Policy Act of 1969 requires all federal agencies to ensure

that the human environment is given consideration in all

agency decision-making. Since January 1, 1986,

applications for new broadcast stations and modifications

of existing stations must contain either an environmental

assessment that will serve as the basis for further

Commission review and action, or an indication that

operation of the station will not have a significa

nt

environ

mental impact. See 47 C.F.R. §1.1307(b). In this

regard, applicants are required to look at eight

environmental factors. These factors are relatively self-

explanatory, except for the evaluation of whether the station

adequately protects the public and workers from potentially

harmful radiofrequency (RF) electromagnetic fields.

Worksheet #3 includes both a general environmental

evaluation and specific sub-sections for RF exposure

analysis. These pages are d

esigned to facil

itate and

substantiate the Environmental Effects certification. Their

use is voluntary, but strongly encouraged.

B. New RF Exposure Requirements. In 1996, the

Commission adopted new guidelines and procedures for

evaluating environmental effects of RF emissions. All

applications subject to environmental processing filed on

or after October 15, 1997 must demonstrate compliance

with the new requirements. These new guidelines

incorporate two tiers of exposure limits:

General population/uncontrolled exposure limits apply to

situations in which the general public may be exposed or in

which persons who are exposed as a consequence of their

employment may not be made fully aware of the potential

for exposure or cannot exercise control over their

exposure. Members of the general public are always

considered under this category when exposure is not

employment-related.

Occupational/controlled exposure limits apply to human

exposure to RF fields when persons are exposed as a

consequence of their employment and in which those

persons who are exposed have been made fully aware of

the potential for exposure and can exercise control over

their exposure. These limits also apply where exposure is of

a transient nature as a result of incidental passage through

a location where exposure levels may be above the general

populations/uncontr

oll

ed limits as long as the exposed

person has been made fully aware of the potential for

exposure and can exercise control over his or her exposure

by leaving the area or some other appropriate means.

The new guidelines are explained in more detail in OET

Bulletin 65, entitled Evaluating Compliance with FCC

Guidelines for Human Exposure to Radiofrequency

Electromagnetic Fields, Edition 97-01, released August,

1997, and Supplement A: Additional Information for Radio

and Television Broadcast Stations (referred to here as

"OET Bulletin 65" and "Supplement A," respectively).

Both OET Bulletin 65 and Supplement A can be viewed

and/or downloaded from the FCC Internet site at

htt

p://www/fcc.gov/oet/rfsafety. Copies can also be

purchased from the Commission's duplicating/research

contractor,

B

C

P

I,

785

1

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Bee

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,

Gait

her s u r g , M D

2087

9 (telephone: (301) 857- 3800;

fax: (202) 857-3805) or 445 12th Street SW, Rm CY-

C401, Washington, DC 20554. Additional information

may be obtained from the RF Safety Group at

rfsafety@fcc.gov

or (202) 418-2464 or from the FCC

Call Center at

1-888-CALL

FCC (225-5322).

The RF worksheets and tables appended to Worksheet 3

below will enable certain categories of stations to

determine whether or not the proposed facility will have

a significant environmental impact as defined by Section

1.1307. All applicants can use the General

Environmental Worksheet. Some, but not all, stations will

be able to use the RF worksheets. Generally, the RF

worksheets can only be used in the following situations:

(1) single use tower; (2) single tower with several

FM/FM translators; or (3) a multiple tower AM array

with no other user co-located within the array.

Additionally, the RF worksheets can be used in regard to

an AM station only if access to the AM station is

restricted by a fence or other barrier that will preclude

casual or inadvertent access to the site and warning

signs are posted at appropriate intervals de

scribing the

potential for RF exposure. See "RF Exposure

Compliance Worksheet Instructions" for more detail on

eligibility.

If after using the worksheets the applicant finds that levels

will exceed the RF guidelines, levels may still be

acceptable based on a more detailed evaluation of a

number of variables (e.g., antenna radiation patterns or

measurement data). In that case, the applicant must

submit an exhibit to the application that explains why the

proposed facility does not exceed the RF radiation

exposure guidelines at locations where humans are likely

to be present or that describes measures or

circumstances, which will prevent or disc

ourage humans

from entering those areas where the RF exposure exceeds

the guidelines (e.g., fencing or remote location). The

guidelines are explained in more detail in OET

Bulletin

65.

If the applicant is not eligible to use the worksheets, it is not

an indication that the proposed facility will cause excessive

exposure. Generally, applicants that are not able to use the

worksheets will need to utilize more complex calculations

or measurements to demonstrate compliance. For

this reason, a p p l i c a n t s w h o a r e n o t e lig i b l e

t

o

u

s e te worksheets should consider seeking the

assistance of a qualified consulting engineer in determining

whether the proposed facility will meet the

RF exposure

guidelines

Should the applicant be unable to conclude that its proposal will

have no significant impact on the quality of the human

environment, it must submit an Environmental Assessment

containing

the following information:

(1) A description of the facilities as well as supporting

structures and appurtenances, and a

de

s

c

r

i

p

t

i

on

o

f the

site as well as the surrounding area and uses. If high-

intensity white

l

i

ghti

ng is

pr

oposed or utilized within a

residential area, the EA must also address the impact of this

lighting upon the residents.

(2) A statement as to the zoning classification of the site, and

communications with, or proceedings before and

determinations (if any) by zoning, planning,

environmental and other local, state, or federal authorities

on matters relating to

environmental

effects.

(3) A statement as to whether construction of the facilities has

been a source of controversy on environmental grounds in

the local community.

(4) A discussion of environmental and other considerations that

led to the selection of the particular site and, if relevant, the

particular facility; the nature and extent of any unavoidable

adverse environmental effects; and any alternative sites or

facilities that have been or reasonably might be considered.

(5) If relevant, a statement why the site cannot meet the

FCC guidelines for RF exposure with respect to the

public and workers.

BROADCAST FACILITY

A. Section 73.616: DTV Station Interference Protection.

The applicant must certify that the proposal will not cause

or increase interference to any other DTV broadcast

application, DTV allotment, or analog TV broadcast

authorization. Interference is to be predicted in accordance

with the procedure set forth in the Third DTV Periodic

Report and Order in MB Docket No. 07-91. See 47

C.F.R. § 73.616. If applicant cannot certify “Yes,” the

applicant must demonstrate that the proposal will not cause

or increase interference to any other DTV broadcast

application, DTV allotment, or analog TV broadcast

authorization.

B. Section 73.622(i): DTV Table of Allotments. The

applicant must certify compliance with the digital television

channel allotment and operational requirements contained in

47 C.F.R. §73.622(i). Specifically, this question requires that

the applicant certify that the application specifies a channel

and community in accordance with the Commission's Table

of Television Allotments, 47 C.F.R. § 73.622(i), that it

will operate a facilities that does not expand the noise-

limited service contour in any direction beyond that

established by Appendix B of the Seventh Report and

Order in MB Docket No. 87-268 establishing the new

DTV Table of Allotments in 47 C.F.R. § 73.622(i), and that

it will operate at post-transition facilities that match or

reduce by

no more than five percent with respect to

predicted population from those defined in the new DTV

Table

Appendix

B.

C. Section 73.623(e): Protection of land mobile operations

on channels 14–20. The Commission will not accept

petitions to amend the DTV Table of Allotments,

applications for new DTV stations, or applications to

change the channel or location of authorized DTV stations

that would use channels 14–20 where the distance between

the DTV reference point as defined in 47 C.F.R.

§73.622(d), would be located less than 250 km from the

city center of a co-channel land mobile operation or 176

km from the city center of an adjacent channel land mobile

operation. Petitions to amend the DTV Table,

applications for new DTV stations, or requests to modify

the DTV Table that do not meet the minimum DTV–to–

land mobile spacing standards will, however, be

considered where all affected land mobile licensees

consent to the requested action. For the markets and

channels that Land mobile operations are authorized in see

47 C.F.R. §73.623(e).

D. Section 73.625: Community Coverage. The applicant

must certify that the proposed facility complies with the

Commission's community coverage requirements. The

principal community contour is as follows for digital

television

stations:

Channels 2-6: 28 dBμ

Channels 7-13: 36 dBμ

Channels 14-69: 41 dBμ

To determine if the proposed facility complies with the

requirements of section 73.625(a) and (b), the predicted

distance to the pertinent signal-strength contour must be

calculated using the standard methodology in 47 C.F.R.

§73.625(b)

E. Section 73.1030: Notifications Concerning Interference

to Radio Astronomy, Research, and Receiving

Installations. All applicants must comply with the

requirements of section 73.1030. Applicants must notify

United States Government radio astronomy installations,

radio receiving installations, and FCC monitoring stations of

the proposed facility and its possible impact on their

operations. The Commission need not be informed of the

date of such notification.

F. Section 73.1125: Main Studio Location. The applicant

must certify that its proposed main studio location complies

with the requirements of 47 C.F.R. Section 73.1125. In

order to answer "Yes" to this q u e s tio n , t h e

applicant's proposed main studio must be either (1) within

the principal community contour of any station licensed

to that community; or (2) within 25 miles from the

reference coordinates of the center of its community of

license. A community's reference coord

inates are generally

the coordinates listed in the United States Department of

the Interior publication entitled Index to the National

Atlas of the United States. An alternative reference point,

if none is listed in the Atlas, is the coordinates of the

community's main Post Office.

In order to qualify as a "main studio," the proposed

location must be equipped with type-accepted equipment

and capable of originating programming at any time.

Additionally, the studio must be staffed by at least one

management-level employee and one staff-level employee

at all times during regular business hours. See Jones,

Eastern of the Outer Banks, Inc., 6 FCC Rcd 3615

(1991), clarified, 7 FCC Rcd 6800 (1992), aff'd 10 FCC

Rcd 3759 (1995). Additionally, each TV

broadcast station

must at all times maintain a toll-free telephone line from its

community of license to its main studio, wherever located.

LEGAL

CERTIFICATIONS

A. Character Issues and Adverse Findings. The Character

Issues Section requires the applicant to certify that neither it

nor any party to the application has had any interest in or

connection with an application that was or is the subject of

unresolved character issues. An applicant must disclose in

the Adverse Finding Section whether the applicant or any

party to the application has been the subject of a final

adverse finding with respect to certain relevant non-

broadcast matters. The Commission's character policies and

litigation reporting requirements for broadcast applicants

focus on misconduct which violates the Communications Act

or a Commission rule or policy and on certain specified non-

FCC misconduct. In responding to these Sections,

applicants should review the Commission's character

qualifications policies, which are fully set forth in Character

Qualifications, 10

2 FCC 2d 1179 (1985), reconsideration

denied, 1 FCC Rcd 421 (1986), as modified, 5 FCC Rcd

3252 (1990) and 7 FCC Rcd 6564 (1992).

Where the response to either Character issue question is

"Yes," the applicant must submit an exhibit that includes an

identification of the party having had the interest, the call

letters and location of the station or file number of the

application or docket, and a description of the nature of the

interest or connection, including relevant dates. The

applicant should also fully explain why the unresolved

character issue is not an impediment to a grant of this

application.

In responding to the Adverse Finding Section, the applicant

should consider any relevant adverse finding that occurred

within the past ten years. Where that adverse finding was

fully disclosed to the Commission in an application filed on

behalf of this station or in another broadcast station

application and the Commission, by specific ruling or by

subsequent grant of the application, found the adverse

finding not to be disqualifying, it need not be reported

again and the applicant may respond "No" to this item.

However, an adverse finding that has not been reported to

the Commission and considered in connection with a prior

application would require a "Yes" response.

Where the response to the Adverse Finding question is

"Yes," the applicant must provide in an exhibit a full

disclosure of the persons and matters involved, including an

identification of the court or administrative body and the

proceeding (by dates and file numbers), and the

disposition of the litigation. Where the requisite

information has been earlier disclosed in connection with

another pending application, or as required by 47 C.F.R.

§1.65(c), the applicant need o

nly provide an identification of

that previous submission by reference to the file number in

the case of an application, the call letters of the station

regarding which the application or section 1.65 information

was filed, and the date of filing. The applicant should also

fully explain why the adverse finding is not an impediment

to a grant of this application.

B. Program Service Certification. Applicants for

broadcast construction permits need no longer file a

specific program service proposal. Nevertheless, prior

to making the certification, the applicant should

familiarize itself with its obligation to provide

programming responsive to the needs and interests of

the residents of its community of license. See

Programming Information in Broadcast Applications, 3

FCC Rcd 5467 (1988).

C. Local Public Notice.

(1) 47 C.F.R. § 73.3580 requires that applicants for

construction permits for new broadcast stations and

for major change in existing broadcast facilities (as

defined in 47 C.F.R. §73.3572(a)(1)) give local

notice in a newspaper of general circulation in the

community to which the station is licensed. This

publication requirement also applies with respect to

major amendments as defined in 47 C.F.R.

§73.3772(b). Local notice is also required to be

broadcast over the station, if

operating. However,

if the station is the only operating station in its

broadcast service licensed to the community

involved, publication of the notice in a newspaper is

not required.

(2) Completion of publication may occur within 30

days before or after the tender of the application to

the Commission. Compliance or intent to comply

with the public notice requirements must be certified

by the applicant in Item 9 of Section II of this

application. The required content of the local notice is

described in Paragraph (f) of 47 C.F.R. § 73.3580.

Worksheet #1 attached to these instructions provides

additional guidance. Proof of publication need not

be file

d with this application.

D. Auction Authorization. The Commission's Part

1 auction rules require all winning bidders for

construction permits or licenses to include certain

exhibits with their long-form applications. If this

application is being submitted to obtain a

construction permit for which the applicant was a

winning bidder in an auction, then the applicant must,

pursuant to 47 C.F.R. Section 73.5005(a), include an

exhibit containing the information required by the

following Part 1 auction rules, if applicable. (1) Section

1.2107(d) requires the applicant to provide a detailed

explanation of the terms, conditions,

and parties involved

in any bidding consortium, joint venture, partnership, or

other agreement or arrangement it had entered into relating

to the competitive bidding process. See 47 C.F.R. Section

1.2107(d). (2) Section 1.2110(j) requires applicants

claiming designated entity status to describe how

they satisfy the requirements for eligibility for such status,

and to list and summarize all agreements that affect

designated entity status, such as partnership agreements,

shareholder agreements, manage

ment agreements, and any

other agreements, including oral agreements, which

establish that the designated entity will have both de facto

and de jure control of the entity. See 47 C.F.R. Section

1.2110(j). (3) Section 1.2112(a) requires that each long-

form application fully disclose the real party or parties in

interest and disclose specified ownership information,

including identifying any party holding a 10 percent or

greater interest in the applicant. See 47 C.F.R. Section

1.2112(a). (4) Section 1.2112(b) requires

each

applicant claiming status as a "small business" to

disclose specified gross revenue information; to list and

summarize all agreements or instruments that support the

applicant's eligibility as a small business, including the

establishment of de facto and de jure control; and to list

and summarize any investor protection agreements. See

47 C.F.R. Section 1.2112(b).

E. Equal Employment Opportunity (EEO)

Applicants seeking authority to construct a new

commercial broadcast station are required to afford equal

employment opportunity to all qualified persons and to

refrain from discriminating in employment and related

benefits on the basis of race, color, religion, national

origin or sex. See 47 C.F.R. § 73.2080. Pursuant to

these requirements, an applicant who proposes to employ

five or more full-time employees in its station employment

unit must establish a

program designed to assure equal

employment opportunity for women and minority groups

(that is, Blacks not of Hispanic origin, Asian or Pacific

Islanders, American Indians or Alaskan Natives, and

Hispanics). This program is submitted to the Commission

as the Model EEO Program on FCC Form 396-A, which

should be filed simultaneously with this application. If

an applicant proposes to employ less than five full-time

employees in its station employment unit, no EE

O

program for women or minorities need be filed. General

guidelines for developing an Equal Employment

Opportunity program

are set forth in FCC Form 396-A.

F. Anti-Drug Abuse Act Certification. This question

requires the applicant to certify that neither it nor any party to

the application is subject to denial of federal benefits

pursuant to the Anti-Drug Abuse Act of 1988, 21

U.S.C.§ 862.

Section 5301 of the Anti-Drug Abuse Act of 1988

provides federal and state court judges the discretion to

deny federal benefits to individuals convicted of offenses

consisting of the distribution or possession of controlled

substances. Federal benefits within the scope of the statute

include FCC authorizations. A "Yes" response constitutes

a certification that neither the applicant nor any party to

this application has been convicted of such an offense

or, if it has, it is not ineligible to receive the authorization

sought by this application because of section 5301.

With respect to this question only, the term "party to the

application" includes if the applicant is an individual, that

individual; if the applicant is a corporation or unincorporated

association, all officers, directors, or persons holding 5

percent or more of the outstanding stock or shares (voting

and/or non-voting) of the applicant; all members if a

membership association; and if the applicant is a

partnership, all general partners and all limited partners,

incl

uding both insulated and non-insulated limited partners,

holding a 5 percent or more interest in the partnership.

INSTRUCTIONS FOR SCHEDULE B –SCHEDULE

FOR DIGITAL TELEVISION BROADCAST

STATION LICENSE

A. Channel and Facility Information and Antenna

Location and Technical Data. The applicant must ensure

that the facility specifications are accurate. Conflicting data

found elsewhere in the application will be disregarded.

All items must be completed. The response "on

file" is not acceptable. The response "not applicable" is

not acceptable unless otherwise noted.

LICENSE APPLICATION

CERTIFICATIONS

B. Constructed Facility. The applicant must certify that

the facility was constructed as authorized in the

underlying construction permit. If there are any differences

between the facilities constructed compared with those

authorized in the construction permit, the applicant may

need to seek approval for the change on FCC Form 2100

Schedule A.

C. Special Operating Conditions: The special operating

conditions are located on the final pages of the

construction permit. Attach exhibits, if required, to

document compliance with the special operating

conditions.

NOTE: Special operating conditions may

prohibit automatic program test authority.

D. Transmitter. A permittee or licensee installing as a main

transmitter one that is not included on the FCC’s “Radio

Equipment List, Equipment Acceptable for Licensing,”

must have first obtained authority to use such a

transmitter through the filing and grant of FCC Form

2100 Schedule A.

CHANGING TRANSMITTER

POWER OUTPUT.

Applicants proposing to replace an omnidirectional

antenna with another omnidirectional antenna or change

transmitter output power as a result of modifying the

transmission line system must check "Yes". NOTE: If

the applicant is proposing to replace an omnidirectional

antenna with another omnidirectional antenna, the new

antenna must be mounted not more than two meters

above nor four meters below the authorized values. See

47 C.F.R. Section 73.1690(c)(1). If the applicant is

proposing to change transmitter output power by

r

eplacing its transmission line, the station's effective

radiated power must not change. See 47 C.F.R.

Section73.1690(c)(10). If the proposal meets these

requirements, program test operations may commence

at full power pursuant to Section 73.1620(a)(1).

A. Replacing a directional antenna.

This question is to be answered by applicants replacing a

directional antenna with another directional antenna. See 47

C.F.R Section 73.1690(c)(3). It requires the applicant to

certify and provide an exhibit demonstrating that: (1) the

proposed theoretical antenna pattern will not exceed the

licensed directional pattern at any azimuth and no change in

effective radiated power will result; and (2) the requested

modification of license complies with 47 C.F.R. Section

73.685(f).

NOTE: The new antenna must be mounted not more than

two meters above nor four meters below the authorized

values.

B. Use a formerly licensed main facility as an auxiliary

facility.

This question set forth a series of certifications for

applicants proposing the use of a formerly licensed main

facility as an auxiliary facility. This question requires the

applicant to certify and submit an exhibit showing that the

proposed auxiliary facilities will not extend beyond the

Grade B coverage area of the main antenna after the change in

ERP has been effectuated. See 47 C.F.R. Section

73.1675(a).

C. Change the license status.

Applicants may change their license status from commercial

to noncommercial or from noncommercial to commercial.

However, if changing from commercial to noncommercial

educational status, the applicant must submit as an exhibit a

completed Section II of FCC Form 340, establishing its

qualifications to operate the subject facility as a

noncommercial educational station. See 47

C.F.R. Section 73.1690(c)(9).

FCC NOTICE REQUIRED BY THE PAPERWORK

REDUCTION

ACT

We have estimated that each response to this collection of

information will take from 3 to 6.25 hours. Our estimate

includes the time to read the instructions, look through

existing records, gather and maintain the required data,

and actually complete and review the form or response. If

you have any comments on this burden estimate, or on

how we can improve the collection and reduce the burden it

causes you, please e-mail them to pra@fcc.gov

or send

them to the Federal Communications Commission, AMD-

PERM, Paperwork Reduction Project (3060-0027),

Washington, DC 20554. Please DO NOT SEND

COMPLETED APPLICATIONS TO THIS ADDRESS.

Remember - you are not required to respond to a

collection of information sponsored by the Federal

government, and the government may not conduct or

sponsor this collection, unless it displays a currently valid

OMB control number or if we fail to provide you with this

notice. This collection has been

assigned an OMB control

number of 3060-0027.

THE FOREGOING NOTICE IS REQUIRED BY THE

PRIVACY ACT OF 1974, P.L. 93-579, DECEMBER

31, 1974, 5 U.S.C. § 552a(e)(3), AND THE PAPERWORK

REDUCTION ACT OF 1995, P.L. 104-13, OCTOBER

1, 1995, 44 U.S.C. § 3507.

FCC Form 2100, Schedule 381

Instructions

May

2015

Federal Communications Commission Approved by OMB

Washington, D.C. 20554 3060-1206

INSTRUCTIONS FOR FCC FORM 2100,

SCHEDULE 381

PRE-AUCTION TECHNICAL

CERTIFICATION FORM

GENERAL

INSTRUCTIONS

This form must be completed by full power and Class A

television licensees with a facility eligible for

relinquishment in the broadcast television incentive

auction and protection in the repacking process

(“Eligible Facility”), as listed in a Public Notice

released by the Media Bureau (“Eligibility PN”). See

Expanding the Economic and Innovative Opportunities

of Spectrum Through Incentive Auctions, GN No. 12-

268, Report and Order, 29 FCC Rcd 6567, 6651, n. 615

(2014)(“Incentive Auction Report and Order”).

Completion of this form will enable the Commission to

ensure the accuracy of the technical data in its database

for these Eligible Facilities and facilitate the incentive

auction repacking process. Id. at 6651, n. 615.

Licensees must certify that all information provided on

this Form is correct to the best of the licensee’s

knowledge.

Item 1: Database Certification

The licensee must certify that it has reviewed the

authorization for its Eligible Facility as well as the

“database technical information” related to the

authorization and confirm that all information is correct

with respect to actual operations. “Database technical

information” includes all underlying technical data that

sets forth the operational parameters of the Eligible

Facility, including but not limited to technical

information that may be found in the Commission’s

Consolidated Database System (and its successor the

Licensing Management System) and Antenna

Registration System (“Database Technical

Information”). This Form will prefill with the

authorization file number for the Eligible Facility about

which the licensee must make its certification.

In making its certification the licensee must either

indicate that:

A. the authorization for the Eligible Facility and all

underlying Database Technical Information is

accurate and complete, to the best of its

knowledge;

B. the authorization for the Eligible Facility is

inaccurate because of a discrepancy between the

authorization and the underlying Database Technical

Information on file with the Commission (in which

case it must supply an explanatory exhibit); or

C. it is operating the Eligible Facility with parameters

at variance from those specified in its authorization

and the database technical information. In this

case, the licensee must file an application for

modification of its facility (FCC Form 2100,

Schedule A) to correct the discrepancy and a

request for special temporary authority to operate

with parameters at variance pursuant to Section

73.1635 of the Commission’s Rules, 47 C.F.R. §

73.1635. If such application(s) have already been

filed, the licensee must supply the file number for

the application(s). Note that modifications to the

Eligible Facility made to correct unauthorized

operations will not be considered in determining the

scope of the Eligible Facility’s spectrum usage rights

eligible for relinquishment in the broadcast television

incentive auction and for protection in the repacking

process. The Eligible Facility considered for these

purposes will be based on the parameters in the

Eligibility PN.

Item 2: Information on Eligible Facility

The licensee must provide details concerning the Eligible

Facility. Because distributed transmission system

(DTS) facilities are comprised of multiple antenna

locations, licensees of DTS facilities will need to

complete this item for each facility that is part of their

license authorization.

A. Transmitter. The licensee must provide

information concerning the Eligible Facility’s

primary transmitter, including the make and

model of the transmitter (exclude all dashes and

spaces); the maximum power output capacity of

the transmitter according to the manufacturer’s

specifications; and transmitter type (tube or solid

state). Licensee should provide this information

for the main transmitter used in operation of the

Eligible Facility.

B. Antenna. The licensee must provide information

concerning the Eligible Facility’s primary

antenna including:

(1) Indicating the type of antenna from the list

provided (or, if the type is not listed,

selecting “other” and providing an

explanatory exhibit;

(2) Indicating whether its primary antenna is

capable of operating on multiple channels

(e.g., broadband) and, if so, identifying the

frequency range (in megahertz);

(3) Indicating whether it shares its antenna with

another broadcaster(s) and, if so, with whom

by listing the facility identification number(s)

and call-sign(s) (only valid Facility ID Numbers

and Call-Signs will be accepted by the system);

and

(4) Specifying, by choosing all that apply, where

the antenna is located on the antenna support

structure (or, if none of the options or

additional options apply, selecting “other”

and providing an explanatory exhibit).

C. Transmission Line. The licensee must provide

information concerning the Eligible Facility’s

principal transmission line, which is the line that

links the main transmitter to the primary antenna.

For purposes of this question the principal

transmission line is defined as the part of the

transmission line that consists of 90% or more of

the entire transmission system. It must identify

the type of transmission line and, if “rigid,” must

select one of the lengths from the options

provided. If no single component consists of

90% or more of the entire transmission system,

include an explanatory exhibit.

D. Antenna Support Structure. For the antenna

support structure (e.g., the tower, building, etc.)

on which the Eligible Facility’s primary antenna

is located, the licensee must indicate:

(1) The year in which a structural analysis was

last conducted (or, if no structural analysis

has been conducted the licensee must select

“other” and provide an exhibit explaining why

no analysis has been conducted);

(2) Under which version of the ANSI/TIA-222

standard “Structural Standards for Antenna

Supporting Structures and Antennas” was the

last analysis conducted (or. if none of the

options apply, the licensee must select “other”

and provide an exhibit in which it indicates

under which structural analysis, if any, the

structure was last analyzed; and

(3) Whether the antenna support structure on which

its primary antenna is located is owned by the

licensee, including any entity under common

ownership as the licensee (e.g., a subsidiary or

parent company) or leased from a third-party. If

the latter, it must provide the name of the lessor.

If the licensee does not own its antenna support

structure it may need to contact the structure owner to

obtain the information requested in (1) and (2).

FCC NOTICE TO INDIVIDUALS REQUIRED BY THE

PRIVACY ACT AND THE PAPERWORK REDUCTION

ACT

The FCC is authorized under the Communications Act of 1934,

as amended, to collect the personal information we request in

this form to ensure that all data in the Commission’s database is

accurate in order to conduct the incentive auction and repacking

process. If we believe there may be a violation or potential

violation of a FCC statute, regulation, rule or order, your form

may be referred to the Federal, state or local agency responsible

for investigating, prosecuting, enforcing or implementing the

statute, rule, regulation or order. In certain cases, the

information in your form may be disclosed to the Department of

Justice or a court or adjudicative body when (a) the FCC; (b)

any employee of the FCC; or (c) the United States Government

is a party to a

proceeding before the body or has an interest in

the proceeding. In addition, all information provided in this

form will be available for public inspection.

If you owe a past due debt to the federal government, any

information you provide may also be disclosed to the

Department of Treasury Financial Management Service, other

federal agencies and/or your employer to offset your salary, IRS

tax refund or other payments to collect that debt. The FCC may

also provide this information to these agencies through the

matching of computer records when authorized.

Your verification of the accuracy of the technical information

on file with the Commission and provision of details

concerning your Eligible Facility is important in order for

the Commission to conduct the incentive auction and repacking

process. An incomplete form will not be accepted for filing. An

inadvertently accepted form is subject to return. If a licensee

fails to file a complete form prior to the deadline specified

in the Eligibility PN, all technical data on file with the

Commission related to its Eligible Facility will be

considered accurate and will be used to determine the

scope of the Eligible Facility’s spectrum usage rights

eligible for relinquishment in the broadcast television

incentive auction and for protection in the repacking

process.

We have estimated that it will take respondents on average 2

hours to complete this collection of information. Our estimate

includes the time to read the instructions, look through existing

records, gather and maintain the required data, and actually

complete and review the form or response. If you have any

comments on this estimate, or on how we can improve the

collection and reduce the burden it causes you, please write the

Federal Communications Commission, AMD-PERM,

Paperwork Reduction Project (3060-1206), Washington, DC

20554. We will also accept your comments via the Internet if

you send them to Leslie.Smit[email protected].

Please DO NOT

SEND COMPLETED FORMS TO THIS ADDRESS.

Remember - you are not required to respond to a collection of

information sponsored by the Federal government, and the

government may not conduct or sponsor this collection, unless it

displays a currently valid OMB control number or if we fail to

provide you with this notice. This collection has been assigned

an OMB control number of 3060-1206.

THE FOREGOING NOTICE IS REQUIRED BY THE

PRIVACY ACT OF 1974, P.L. 93-579, DECEMBER 31,

1974, 5 U.S.C. § 552a(e)(3), AND THE PAPERWORK

REDUCTION ACT OF 1995, P.L. 104-13, OCTOBER 1,

1995, 44 U.S.C. § 3507.

Approved by OMB

Federal Communications Commission

Washington, D C 20554

FOR

3060-1206

FCC

FCC Form 2100, Schedule 381

Pre-Auction Technical Certification Form

USE

ONLY

FOR COMMISSION USE ONLY

FILE NO.

Database Certification (select only one)

FCC Form 2100, Schedule 381

May 2015

1.

Licensee hereby certifies that it has reviewed its license authorization/construction permit and underlying Database Technical

Information for its Eligible Facility as reflected in File No.

and

a.

it is accurate and complete to the best of its knowledge.

it is not accurate because of a discrepancy between the license authorization and

underlying Database Technical Information.

If (b) is selected, licensee must explain in the exhibit the discrepancies.

b.

c.

it is not accurate because the licensee is operating the Eligible Facility with parameters at

variance from those specified in the authorization and the Database Technical

Information.

If (c) is selected, the licensee must file an application for modification of its facility

(FCC Form 2100, Schedule A) to correct the discrepancy and a request for special

temporary authority to operate with parameters at variance. If such application(s) has

already been filed, the licensee must supply the file number for the application(s): File

No(s).

Information on Eligible Facility

2.

For the Eligible Facility indicated in Item 1:

a.

Transmitter. Provide the following information about the main transmitter(s) used by

the Eligible Facility for its primary facility:

(1) Make

(2) Model

(3) Maximum Power output capacity (in kilowatts)

(4) Transmitter type (select one)

Tube

Solid State

b.

Antenna. Provide the following information about the Eligible Facility's primary antenna:

(1) Antenna Type (select one)

Slot

Panel

Traveling wave

Spiral

Batwing

Other

[If "Other" is selected, explain in exhibit]

Exhibit No.

Please read the Instructions before filling out the form.

(2)

Is the primary antenna capable of operating over multiple channels (e.g., broadband)?

No

Yes

Exhibit No.

FCC Form 2100, Schedule 381

(Page 2)

Exhibit No.

If yes, select the antenna's frequency range (in megahertz):

To

From

(3)

Is the primary antenna shared with another television station?

No

Yes

If yes, with which station?

Facility ID Number Call Sign

(4)

Antenna Location (Select all that apply):

Side Mount

Top Mount

Candelabra

Stacked-Top

Stacked-Bottom

Other

[If "Other" is selected, explain in exhibit]

c.

Transmission Line. Provide the following information for the Eligible Facility's principal

transmission line used to connect its main transmitter to its primary antenna:

20 feet

19.75 feet

19.50 feet

Broadband/Varied Length

[If no single component consists of 90% or more of the entire transmission system, include an explanatory

Exhibit.]

(1)

Type of transmission line (select one):

Flexible

Rigid

If rigid, what length sections:

d.

Antenna Support Structure. Provide the following information related to the antenna support

structure for the Eligible Facility's primary antenna

(1)

In what year was the last structural analysis conducted on the structure? (select one)

Select Year

Other

[If "Other" is selected, explain in exhibit]

Exhibit No.

(2)

Under what structural standard was the last structural analysis conducted? (select one)

TIA 222-Revision F

TIA 222-Revision G

[If "Other" is selected, explain in exhibit]

Other

(3)

Does the licensee own this antenna support structure? (select one)

No

Yes

If no, provide the name of the third-party entity that owns the antenna support structure: