Go to the Federal Communications Commission homepage at www.fcc.gov

Licensing and Management System

Approved by OMB 3060-0906
May 2015
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission)Annual DTV Ancillary/Supplementary Services Report

File Number:
0000005869
Submit Date:
11/13/2015
Call Sign:
K41JS-D
Facility ID:
167576
FRN:
0008794109
State:
Utah
City:
GREEN RIVER
Service:
LPT
Purpose:
Annual Ancillary/Supplemental Service Report
Status:
Received
Status Date:
11/13/2015
Filing Status:
Active


General Information

Section Question Response
Attachments Are attachments (other than associated schedules) being filed with this application? No

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

GREEN RIVER CITY TELEVISION

Doing Business As: GREEN RIVER CITY TELEVISION

P.O. BOX 620

GREEN RIVER, UT 84525

United States

+1 (435) 381-3425 BRET.MILLS@ECSO.UTAH.GOV Government Entity

Authorization Holder Name

Contact Representatives (1)

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Contact Name Address Phone Email Contact Type

BRET MILLS

COMMUNICATIONS SPECIALIST

EMERY COUNTY

PO Box 817

CASTLEDALE, UT 84513

United States

+1 (435) 381-3425 BRET.MILLS@ECSO.UTAH.GOV Legal Representative

Ancillary/Supplementary Services

Call Sign City State Licensee
K42HP-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K41JS-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K44IK-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K43KG-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K47KX-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K45JV-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K17HW-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K16HD-D GREEN RIVER UT GREEN RIVER CITY TELEVISION
K15HH-D GREEN RIVER UT GREEN RIVER CITY TELEVISION

Certification

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Section Question Response
General Certification Statements The Applicant waives any claim to the use of any particular frequency or of the electromagnetic spectrum as against the regulatory power of the United States because of the previous use of the same, whether by authorization or otherwise, and requests an Authorization in accordance with this application (See Section 304 of the Communications Act of 1934, as amended.).
The Applicant certifies that neither the Applicant nor any other party to the application is subject to a denial of Federal benefits pursuant to §5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. §862, because of a conviction for possession or distribution of a controlled substance. This certification does not apply to applications filed in services exempted under §1.2002(c) of the rules, 47 CFR . See §1.2002(b) of the rules, 47 CFR §1.2002(b), for the definition of "party to the application" as used in this certification §1.2002(c). The Applicant certifies that all statements made in this application and in the exhibits, attachments, or documents incorporated by reference are material, are part of this application, and are true, complete, correct, and made in good faith.
Authorized Party to Sign

FAILURE TO SIGN THIS APPLICATION MAY RESULT IN DISMISSAL OF THE APPLICATION AND FORFEITURE OF ANY FEES PAID

Upon grant of this application, the Authorization Holder may be subject to certain construction or coverage requirements. Failure to meet the construction or coverage requirements will result in automatic cancellation of the Authorization. Consult appropriate FCC regulations to determine the construction or coverage requirements that apply to the type of Authorization requested in this application.

WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Title 18, §1001) AND/OR REVOCATION OF ANY STATION AUTHORIZATION (U.S. Code, Title 47, §312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, §503).

I certify that this application includes all required and relevant attachments. Yes
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

BRET MILLS

COMMUNICATIONS SPECIALIST


11/13/2015

Attachments

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Information not provided.