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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:
0000017943
Submit Date:
11/22/2016
Call Sign:
KEZI
Facility ID:
34406
FRN:
0023422728
State:
Oregon
City:
EUGENE
Service:
DTV
Purpose:
Annual Ancillary/Supplemental Service Report
Status:
Received
Status Date:
11/22/2016
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

OREGON TV LICENSE COMPANY, LLC

Robert S. Prather, Jr.

3282 Northside Parkway

Suite 275

ATLANTA, GA 30327

United States

+1 (470) 355-1944 jburgett@wileyrein.com Limited Liability Company

Authorization Holder Name

Contact Representatives (2)

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Contact Name Address Phone Email Contact Type

John M. Burgett , Esq .

Wiley Rein LLP

1776 K Street, N.W.

Washington, DC 20006

United States

+1 (202) 719-4239 jburgett@wileyrein.com Legal Representative

Keane Laguatan

Director of Technology

KEZI

2975 Chad Dr.

Eugene, OR 97408

United States

+1 (541) 485-5611 keanelaguatan@kezi.com Technical Representative

Ancillary/Supplementary Services

Call Sign City State Licensee
K15BP-D GRANTS PASS OR OREGON TV LICENSE COMPANY LLC
K21BG-D JACKSONVILLE OR OREGON TV LICENSE COMPANY LLC
K46CH-D GOLD HILL OR OREGON TV LICENSE COMPANY LLC
K07JS-D NORTH BEND OR OREGON TV LICENSE COMPANY LLC
K46KS-D ROSEBURG OR OREGON TV LICENSE COMPANY LLC
K51BV-D CAVE JUNCTION OR OREGON TV LICENSE COMPANY LLC
K36HM-D FORT DICK CA OREGON TV LICENSE COMPANY LLC
K23ME-D CAMAS VALLEY OR OREGON TV LICENSE COMPANY LLC
K20BI-D NESIKA BEACH OR OREGON TV LICENSE COMPANY LLC
K21LW-D GAZELLE CA OREGON TV LICENSE COMPANY LLC
K25NI-D MAPLETON OR OREGON TV LICENSE COMPANY LLC
K22LB-D SQUAW VALLEY OR OREGON TV LICENSE COMPANY LLC
K11GT-D EUGENE OR OREGON TV LICENSE COMPANY LLC
K11BX-D SUTHERLIN OR OREGON TV LICENSE COMPANY LLC
K04OS-D REEDSPORT OR OREGON TV LICENSE COMPANY LLC
KDRV MEDFORD OR OREGON TV LICENSE COMPANY LLC
K15JG-D SCOTTSBURG OR OREGON TV LICENSE COMPANY LLC
K17LN-D GOLD BEACH OR OREGON TV LICENSE COMPANY LLC
K43NZ-D PORT ORFORD OR OREGON TV LICENSE COMPANY LLC
K17BA-D YREKA CA OREGON TV LICENSE COMPANY LLC
K27CL-D COOS BAY/NORTH BEND OR OREGON TV LICENSE COMPANY LLC
KDKF KLAMATH FALLS OR OREGON TV LICENSE COMPANY LLC
K07IA-D OAKLAND OR OREGON TV LICENSE COMPANY LLC
K42LH-D WINSTON OR OREGON TV LICENSE COMPANY LLC

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.

Robert S. Prather , Jr. .

Chief Executive Officer


11/22/2016

Attachments

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Information not provided.