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Licensing and Management System

Approved by OMB 3060-1178
July 2019
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission)FCC Form 399: Eligibility Certification

File Number:
0000089555
Submit Date:
10/19/2020
Call Sign:
KWVT-LD
Facility ID:
129197
FRN:
0004317830
State:
Oregon
City:
SALEM
Service:
LPD
Purpose:
Form 399 Eligibility
Status:
Submitted
Status Date:
10/19/2020
Filing Status:
Active


Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Michael Mattson

1335 Picture St

Independence, OR 97351

United States

+1 (503) 409-2181 stcl@comcast.net Individual

Authorization Holder Name

Contact Representatives (3)

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Contact Name Address Phone Email Contact Type

Susan Hansen

Consultant

B. W. St. Clair

Susan Hansen

2305 Vida Shaw Rd.

New Iberia, LA 70563

United States

+1 (303) 378-8209 stcl@comcast.net

Michael Mattson

Michael Mattson

1335 Picture St

Independence, OR 97351

United States

+1 (503) 409-2181 mike@kwvtsalem.com Legal Representative

Michael Mattson

Michael Mattson

1335 Picture St

Independence, OR 97351

United States

+1 (503) 409-2181 mike@kwvtsalem.com Technical Representative

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.

Michael Mattson

Applicant


10/19/2020

Attachments

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File Name Uploaded By Attachment Type Description
Greathouse Memo RE_ Fi 129197.pdf Applicant Form 399 Eligibility Sophia Greathouse Memo re Eligibility
LCC and coverage explained.pdf Applicant Form 399 Eligibility Eligibility Exhibit
LCC and coverage explained.pdf Applicant Form 399 Eligibility Revised LLC Exhibit