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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:
0000017360
Submit Date:
11/15/2016
Call Sign:
K17DM-D
Facility ID:
17643
FRN:
0008736613
State:
Utah
City:
MYTON
Service:
LPT
Purpose:
Annual Ancillary/Supplemental Service Report
Status:
Received
Status Date:
11/15/2016
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

DUCHESNE COUNTY

Doing Business As: DUCHESNE COUNTY

PO Box 910

DUCHESNE, UT 84021

United States

+1 (435) 738-1110 BCASPER@DUCHESNE.UTAH.GOV Government Entity

Authorization Holder Name

Contact Representatives (2)

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Contact Name Address Phone Email Contact Type

DUCHESNE COUNTY

DUCHESNE COUNTY

PO Box 910

DUCHESNE, UT 84021

United States

+1 (435) 738-1100 BCASPER@DUCHESNE.UTAH.GOV Legal Representative

RON TITCOMB

UNIVERSITY OF UTAH TRANSLATOR SPECIALIST

UNIVERSITY OF UTAH

4570 LAKE CREEK ROAD

HEBER CITY, UT 84032

United States

+1 (435) 654-2617 RTICOMB@AOL.COM Technical Representative

Ancillary/Supplementary Services

Call Sign City State Licensee
K31JB-D HANNA, ETC. UT DUCHESNE COUNTY
K34FV-D DUCHESNE UT DUCHESNE COUNTY
K17DM-D MYTON UT DUCHESNE COUNTY
K48GZ-D ROOSEVELT UT DUCHESNE COUNTY
K45MF-D FRUITLAND UT DUCHESNE COUNTY
K35IJ-D HANNA & TABIONA UT DUCHESNE COUNTY
K34IV-D FRUITLAND UT DUCHESNE COUNTY
K47HA-D ROOSEVELT UT DUCHESNE COUNTY
K46IX-D ROOSEVELT UT DUCHESNE COUNTY
K33LA-D DUCHESNE UT DUCHESNE COUNTY
K32HP-D HANNA, ETC. UT DUCHESNE COUNTY
K36IM-D DUCHESNE, ETC. UT DUCHESNE COUNTY
K19EY-D MYTON UT DUCHESNE COUNTY
K42KY-D FRUITLAND UT DUCHESNE COUNTY
K41DM-D FRUITLAND UT DUCHESNE COUNTY
K44LH-D FRUITLAND UT DUCHESNE COUNTY
K36IN-D FRUITLAND, ETC. UT DUCHESNE COUNTY
K32HX-D DUCHESNE UT DUCHESNE COUNTY
K26LL-D UTAHN UT DUCHESNE COUNTY
K34IW-D HANNA, ETC. UT DUCHESNE COUNTY
K39JL-D DUCHESNE UT DUCHESNE COUNTY
K35IK-D DUCHESNE UT DUCHESNE COUNTY
K40IY-D FRUITLAND UT DUCHESNE COUNTY
K30LF-D DUCHESNE UT DUCHESNE COUNTY
K27GN-D MYTON UT DUCHESNE COUNTY
K31JC-D DUCHESNE UT DUCHESNE COUNTY
K43NW-D FRUITLAND UT DUCHESNE COUNTY
K18JU-D UTAHN UT DUCHESNE COUNTY
K21FT-D MYTON UT DUCHESNE COUNTY
K36IL-D HANNA & TABIONA UT DUCHESNE COUNTY
K38MF-D DUCHESNE UT DUCHESNE COUNTY
K25HH-D MYTON UT DUCHESNE COUNTY

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.

Alfred Stringham

COUNTY TRANSLATOR SERVICES DIRECTOR


11/15/2016

Attachments

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Information not provided.