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FCC Form 399: Reimbursement Request

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

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Facility ID:
68136
Service:
DCA
Call Sign:
W47AO-D
Channel:
36 (UHF)
File Number:
0000028237
FRN:
0005012992
Date Submitted:
10/16/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TRIPLE J COMMUNITY BROADCASTING., L.L.C.

Doing Business As: TRIPLE J COMMUNITY BROADCASTING., L.L.C.

Pat Gans

1055 EAST 10TH STREET

HAZLETON, PA 18201

United States

 +1 (570) 459-1869 theresagmi@ptd.net Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 

Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Clarence M Beverage

BROADCAST ENGINEERING CONSULTANT

Communications Technologies, Inc.

PO Box 1130

Marlton, NJ 08053

United States

 +1 (609) 451-5296 CBEVERAGE@COMMTECHRF.COM

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan W47AO CURRENTLY USES AN SWR MODEL SWRSWDDP 4-4-0-0 BROADBAND PANEL ANTENNA WHICH REQUIRES ONLY A POWER DIVIDER FOR CH 36. THE TRANSMITTER IS EXISTING AND CAN BE RETUNED.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Retune Existing
Use Primary (Main)
Ownership Owned
Owner N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer Rohde & Schwarz
Model SCx8302E
Year 2015
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 0.9 kW

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 1.5 kW
Other Power N/A
New Exciter Is a new exciter needed? No

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Retune Existing
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 8
Design power capacity in use 65.0 %
Lower Limit 450.00 MHz
Upper Limit 700.00 MHz
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer SWR
Model SWDDP 4-4-0-0
Year 1994

Primary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

POWER DIVIDER

POWER DIVIDER IS TUNED TO FREQUENCY AND MUST BE REPLACED

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 41° 00' 20.0" N-
Longitude (NAD83) 076° 12' 49.0" W-
Overall Structure Height 144.00 feet
Support Structure Height 144.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 1610.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Triple J Community Broadcasting
Date Constructed 01/01/1989


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Rigging Cost

Remove existing power divider and install new

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 595
Explanation COORDINATION WITH OTHER STATIONS, CONTRACT ENGINEER, FIELD ENGINEER, FCC ATTORNEY, AND 399 PREP.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Attorney Fees and Other Matters

Legal Services

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? No
Does this relocation require Equipment Storage? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $108,230.00 $18,326.38 N/A $15,076.38 N/A
Total for all systems $385,588.25 $186,247.63 N/A $70,947.07 N/A
Primary Transmitter SCx8302E $108,230.00 $18,326.38 $15,076.38
1.5 kW mask filter $3,030.00 $3,326.38 CHANNEL CHANGE - EXISTING FILTER CAN NOT BE RETUNED , per invoice SJ Ramer Inv 19003 tax and freight $3,326.38 N/A
UHF and VHF - minor banding issues $105,200.00 $15,000.00 N/A $11,750.00 N/A

Components

Actual Information Description File Name
1.5 kW mask filter

Component Description:
"Repack: existing SWR, LP broadband UHF antenna SWDDP 0-0-4-4 (CH. 47), W47AO, Berwick, PA"
Amount:
$3,326.38
UHF and VHF - minor banding issues

Component Description:
Contract Engineering Services
Amount:
$11,750.00

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $5,994.25 $5,994.25 N/A $5,994.25 N/A
Total for all systems $385,588.25 $186,247.63 N/A $70,947.07 N/A
Primary Antenna SWDDP 4-4-0-0 $5,994.25 $5,994.25 $5,994.25
POWER DIVIDER $5,994.25 $5,994.25 See attached Quotes # 17012 and 1838R from SJ Ramer Associates. $5,994.25 N/A

Components

Actual Information Description File Name
POWER DIVIDER

Component Description:
W47AO-D-210-Primary Antenna - Power Divider
Amount:
$5,994.25

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $124,250.00 $19,250.00 N/A $13,750.00 N/A
Total for all systems $385,588.25 $186,247.63 N/A $70,947.07 N/A
Primary Tower TOWER $124,250.00 $19,250.00 $13,750.00
Rigging Cost $13,750.00 $13,750.00 see Justifying Quote W47AO Convergence Communications Proposal 15050702 $13,750.00 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $5,500.00 Please see the attached Convergence Communications Proposal #15050702 N/A N/A
Short Tower (less than 500') $84,200.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Rigging Cost

Component Description:
INSTALLATION OF NEW ANTENNA POWER DIVIDER, JUMPERS, CONNECTORS
Amount:
$8,250.00

Component Description:
TOWER STRUCTURAL MAPPING AND STRUCTURAL ANALYSIS FOR UNDOCUMENTED TOWER
Amount:
$5,500.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.
Short Tower (less than 500') Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $120,229.00 $119,852.00 N/A $36,126.44 N/A
Total for all systems $385,588.25 $186,247.63 N/A $70,947.07 N/A
Outside Professional Services $120,229.00 $119,852.00 $36,126.44
Attorney Fees and Other Matters $1,239.00 $1,239.00 N/A $442.50 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $678.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $2,245.87 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $1,750.00 N/A $1,750.00 N/A
Project management of the transition $94,010.00 $99,675.00 W47AO-D Strategic Support Widelity Quote $25,038.20 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,000.00 N/A $678.50 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $1,500.00 N/A $500.00 N/A
Prepare and or review reimbursement form $2,630.00 $4,938.00 Womble Bond Dickinson LLP Invoices #2656709, #2648035 $4,793.37 N/A

Components

Actual Information Description File Name
Attorney Fees and Other Matters

Component Description:
Attorney Other Matters
Amount:
$442.50
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Calls w/client on Form 399 & Form 1876.
Amount:
$678.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Construction Permit Application (Main)
Amount:
$1,017.00

Component Description:
Legal services
Amount:
$1,158.25

Component Description:
Legal services
Amount:
$70.62
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
W47AO FCC MINOR CHANGE APPLICATION FOR CP ENGINEERING AND COORDINATION
Amount:
$1,750.00

Component Description:
W47AO FCC MINOR CHANGE APPLICATION FOR CP ENGINEERING AND COORDINATION
Amount:
$1,750.00
Project management of the transition

Component Description:
Project Management
Amount:
$962.65

Component Description:
Project Management
Amount:
$1,511.90

Component Description:
Project Management
Amount:
$2,970.40

Component Description:
Project Management
Amount:
$2,298.00

Component Description:
Project Management
Amount:
$2,805.50

Component Description:
Project Management
Amount:
$129.00

Component Description:
Project Management
Amount:
$3,654.45

Component Description:
Project Management
Amount:
$2,408.50

Component Description:
Project Management
Amount:
$2,739.50

Component Description:
REVIEW PROJECT, COMPLETE 3RD QTR 387 FORM AND REVIEW
Amount:
$185.00

Component Description:
research, conference calls and discussions, coordination and implementation of completing and filing Form 399s, Quarterly Reports
Amount:
$35,500.00

Component Description:
REVIEW PROJECT, COMPLETE W47AO 387 FORM AND REVIEW
Amount:
$185.00

Component Description:
Project Management
Amount:
$1,639.20

Component Description:
Project Management
Amount:
$2,119.80

Component Description:
Project Management
Amount:
$1,429.30
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Review 2nd Priority Window Modification Applications and send to client for approval; file and send filed copies
Amount:
$118.00

Component Description:
Attention yo problem with these stations Form 1876 relating to the CORES User Name listed; telephone with Theresa
Amount:
$560.50
Perform engineering study for new channel assignment and antenna development

Component Description:
W47AO ENGINEERING STUDY TO CONFIRM THAT THE FCC TRANSITION PATTERN AND CHANNEL CAN BE IMPLEMENTED.
Amount:
$500.00
Prepare and or review reimbursement form

Component Description:
Professional Services
Amount:
$354.00

Component Description:
Prepare and Review
Amount:
$555.00

Component Description:
W47AO-D-590-Prepare and Review Reimbursement Form
Amount:
$1,412.50

Component Description:
W47AO-D Prepare and Review Reimbursement Form
Amount:
$1,454.87

Component Description:
Prepare and Review Reimbursement Form
Amount:
$1,017.00

Component Description:
FCC 399 FORM PROJECT REVIEW, COMPLETE FORM AND REVIEW
Amount:
$555.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $26,885.00 $22,825.00 N/A $0.00 N/A
Total for all systems $385,588.25 $186,247.63 N/A $70,947.07 N/A
Other Expenses $26,885.00 $22,825.00 $0.00
MVPD Notification of Channel Change $7,500.00 $7,500.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $7,500.00 $7,500.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $7,500.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $385,588.25 $186,247.63 $70,947.07

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  3. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

  7. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Joseph S. Gans

Owner/Manager


10/16/2019

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  4. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  5. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

  6. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

  8. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  9. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Joseph S. Gans

Owner/Manager


10/16/2019

Attachments

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