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:
0000006689
Submit Date:
11/30/2015
Call Sign:
K16CG-D
Facility ID:
13836
FRN:
0007251655
State:
Minnesota
City:
ST. JAMES
Service:
LPD
Purpose:
Annual Ancillary/Supplemental Service Report
Status:
Received
Status Date:
11/30/2015
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

COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA

Doing Business As: COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA

David Sunderman

PO BOX 8

MANKATO, MN 56002

United States

+1 (507) 387-7963 dsunderman@benco.org Not-for-Profit

Authorization Holder Name

Contact Representatives (2)

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Contact Name Address Phone Email Contact Type

Shelley Sadowsky Sadowsky , Esq .

Shelley Sadowsky, LLC

5938 Dorchester Way

Rockville, MD 20852

United States

+1 (202) 997-9392 shelley@sadowskycommlaw.com Legal Representative

TOM Uppman

TECHNICAL CONSULTANT

Uppman Technical Services

UPPMAN TECHNICAL SERVICES, INC.

19701 261ST ST.

BELLE PLAINE, MN 56011

United States

+1 (952) 873-6943 TOM@UPPMANTECH.COM Technical Representative

Ancillary/Supplementary Services

Call Sign City State Licensee
K26CS-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K32GX-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K30FN-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K44AD-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K21KF-D FROST MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K23FY-D FROST MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K24JV-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K41IZ-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K47MI-D FROST MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K30KQ-D JACKSON MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K14KE-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K23MF-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K16CG-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K40LA-D JACKSON MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K49HE-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K20LP-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K21DG-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K40BU-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K35KI-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K43MJ-D JACKSON MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA
K31KV-D ST. JAMES MN COOPERATIVE TELEVISION ASSOCIATION OF SOUTHERN MINNESOTA

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.

Martin Imlay

President


11/30/2015

Attachments

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Information not provided.