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:
0000018915
Submit Date:
12/02/2016
Call Sign:
K12CX-D
Facility ID:
64457
FRN:
0007905102
State:
Washington
City:
TONASKET
Service:
LPT
Purpose:
Annual Ancillary/Supplemental Service Report
Status:
Received
Status Date:
12/02/2016
Filing Status:
Active


General Information

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

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

T.V. RECEPTION IMPROVEMENT DISTRICT

Applicant

Doing Business As: T.V. RECEPTION IMPROVEMENT DISTRICT

P. O. BOX 111

OKANOGAN, WA 98840

United States

+1 (253) 737-8269 khchevalier@gmail.com Other

Authorization Holder Name

Contact Representatives (3)

Back to Top
Contact Name Address Phone Email Contact Type

KEVIN CHEVALIER

Chairman, Board of Directors

OKANOGAN TV DIST #1

P.O. Box 111

Okanogan, WA 98840

United States

+1 (253) 737-8269 khchevalier@gmail.com Legal Representative

Susan Hanson

ENGINEERING CONSULTANT

B.W. St.Clair

2355 RANCH DRIVE

WESTMINSTER, CO 80234

United States

+1 (303) 465-5742 STCL@COMCAST.NET Technical Representative

Robert Sanderson

Advisor

none

Robert Sanderson

PO Box 2187

Pateros, WA 98846

United States

+1 (509) 923-2587 res262@gmail.com Technical Representative

Ancillary/Supplementary Services

Call Sign City State Licensee
K10DM-D RIVERSIDE WA T.V. RECEPTION IMPROVEMENT DISTRICT
K10DL-D TONASKET WA T.V. RECEPTION IMPROVEMENT DISTRICT
K08CW-D MALOTT WAKEFIELD WA T.V. RECEPTION IMPROVEMENT DISTRICT
K12CV-D RIVERSIDE WA T.V. RECEPTION IMPROVEMENT DISTRICT
K08CY-D RIVERSIDE WA T.V. RECEPTION IMPROVEMENT DISTRICT
K12CW-D MALOTT WAKEFIELD WA T.V. RECEPTION IMPROVEMENT DISTRICT
K08CX-D TONASKET WA T.V. RECEPTION IMPROVEMENT DISTRICT
K17EV-D OMAK WA T.V. RECEPTION IMPROVEMENT DISTRICT
K10DK-D MALOTT WAKEFIELD WA T.V. RECEPTION IMPROVEMENT DISTRICT
K12CX-D TONASKET WA T.V. RECEPTION IMPROVEMENT DISTRICT

Certification

Back to Top
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.

Robert Elwood Sanderson

Technical Advisor


12/02/2016

Attachments

Back to Top
Information not provided.