Applicant | Address | Phone | Applicant Type | |
---|---|---|---|---|
WORD OF GOD FELLOWSHIP, INC. Doing Business As: Community Television Educators, Inc. |
Arnold Torres AKA COMMUNITY TELEVISION EDUCATORS 12014 WEST 64TH AVENUE ARVADA, CO 80004 United States |
+1 (817) 571-1229 | arnold.torres@daystar.com | Private Not-for-Profit Educational Institution |
Applicant | Address | Phone | |
---|---|---|---|
[Confidential] |
|
|
|
Applicant | Address | Phone | |
---|---|---|---|
Samuel Hariton Engineer Widelity, Inc. |
Samuel Hariton 4031 University Drive Ste 100 Fairfax, VA 22030 United States |
+1 (339) 222-8107 | sam.hariton@widelity.com |
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 | Coordinate with tower owner and other Broadcasters; transition during assigned phase. KRMT will transition by changing its antenna and transmitter. KRMT will not change tower sites. |
Section | Question | Response |
---|---|---|
Transmitter Related Expenses | Do you have transmitter related expenses? | Yes |
Section | Question | Response |
---|---|---|
Existing Transmitter Description | Type of change | Purchase New |
Use | Primary (Main) | |
Description of Use | N/A | |
Ownership | Owned | |
Owner | N/A | |
Site | 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 | |
Model | HDR-30M1A | |
Year | 1995 | |
Type | Inductive Output Tube | |
IOT Power Type | Single | |
Power Capacity | 7.5 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | Yes | |
Manufacturer | ||
Model | ELETXUD3600AC | |
Transmitter Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power capacity | 3.6 kW | |
Justification for New Transmitter | Current transmitter cannot be retuned to new antenna at allotted reduced power level. |
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 | Yes | |
Description | Minimal electric services will be needed to implement new facility. | |
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 |
Name | Description |
---|---|
Primary Transmitter - Other Expense |
Primary Transmitter - Other Expense |
Mask Filter |
Mask Filter |
Primary Transmitter - Installation |
Primary Transmitter - Installation |
Section | Question | Response |
---|---|---|
Antenna Related Expenses | Do you have antenna related expenses? | Yes |
Section | Question | Response |
---|---|---|
Existing Antenna Description | Type of change | Purchase New |
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 | Full Power |
Mounting | Side Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Horizontal | |
Type | Slotted Coaxial | |
Number of Stations Supported | N/A | |
Number of Panels | N/A | |
Design power capacity in use | N/A | |
Lower Limit | N/A | |
Upper Limit | N/A | |
Other Antenna Type | N/A | |
ERP: | 74.8 kW | |
Manufacturer | ||
Model | SWCSD16SLM | |
Year | 2004 |
Section | Question | Response |
---|---|---|
New Antenna Description | Use | Primary (Main) |
Description of Use | N/A | |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | Yes | |
Ownership | Owned | |
Owner | N/A | |
Is antenna shared? | No | |
Is antenna directional? | Yes | |
Will antenna be located on or in close proximity to an antenna farm? | No | |
New Antenna Manufacturer and Types | Class | Full Power |
Mounting | Side Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Elliptical | |
Type | Slotted Coaxial | |
Number of Stations Supported | N/A | |
Number of Panels/Bays | N/A | |
Lower Limit | N/A | |
Upper Limit | N/A | |
Design power capacity in use | N/A | |
Other Antenna Type | N/A | |
ERP: | 49.0 kW | |
Manufacturer | ||
Model | SWEDM8SLS/20-EP | |
Year | 2017 | |
Justification for New Antenna | Existing antenna is non-tunable to new channel. |
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 | N/A | |
Do you need a combiner output splitter/switcher for dual feed lines? | N/A | |
Elbow Complex | Do you require the separate purchase of the Elbow Complex? | No |
Broadband or Single Channel? | N/A | |
Feed Line Size | N/A | |
Side Mount Brackets | Do you require the separate purchase of side mount brackets for a high power antenna? | No |
Pattern Scatter Analysis | Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? | No |
Sweep Test | Do you require the sweep testing of transmission line and antenna? | Yes |
Section | Question | Response |
---|---|---|
Transmission Line Related Expenses | Do you have transmission line related expenses? | Yes |
Section | Question | Response |
---|---|---|
Existing Transmission Line Description | Type of change | Utilize Existing |
Use | Primary (Main) | |
Description of Use | N/A | |
Ownership | Owned | |
Owner | N/A | |
Site | N/A | |
Is the existing transmission line shared with another station or stations? | No | |
Is Transmission Line in operating condition? | Yes | |
Existing Transmission Line Manufacturer and Type | Manufacturer | Andrew |
Type | Flexible Air | |
Diameter | 5 inches | |
Other Diameter | N/A | |
Segment Length | N/A | |
Other Segment Length | N/A | |
Number of parallel runs | 1 | |
Length | 100 feet per run |
Name | Description |
---|---|
Transmission Line - Other Pieces |
Transmission Line - Other Pieces |
Section | Question | Response |
---|---|---|
Tower Equipment or Rigging Costs Changes | Do you have tower equipment or rigging costs changes? | Yes |
Section | Question | Response |
---|---|---|
Existing Tower Description | Type of change | Modify Existing |
Tower Use | Primary (Main) | |
Description of Use | N/A | |
Ownership | Leased | |
Is this tower consider Complex? | No | |
Is this tower currently shared with any other stations? | Yes | |
One or more FM, AM or TV radio broadcaster(s) | Yes | |
Others Types of Users | No | |
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) | 39° 35' 59.0" N- |
Longitude (NAD83) | 105° 12' 35.0" W- | |
Overall Structure Height | 100.00 feet | |
Support Structure Height | 100.00 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 7998.00 feet | |
Structure Type | TOWER - Free Standing or Guyed Structure | |
Tower Owner | Cowskin Broadcasting | |
Date Constructed | 01/01/1980 |
Facility ID | Call Sign | Service |
---|---|---|
12354 | KLDV | FM |
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: | Minor Reinforcements needed |
Section | Question | Response |
---|---|---|
Tower Rigging Costs | Complex Tower | N/A |
Helicopter Services Required | Are helicopter services required? | No |
Section | Question | Response |
---|---|---|
Outside Project Management Services | Do you require outside project management services? | Yes |
Number of Hours | 595 | |
Explanation | KRMT requires outside project management for repack requirements. KRMT does not have sufficient resources in house to handle all activities necessary for on-time completion of the station's build. KRMT will hire an outside firm to support its transition. | |
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 | Yes | |
Quantity | 1 | |
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 | Yes | |
Quantity | 1 | |
NEPA Section 106 environmental review | Yes | |
Environmental Assessment | Yes | |
ASR Modification | No | |
FAA Consultation (including preparation of FAA Form 7460) | Yes | |
Negotiation of Lease and other Matter for Shared Locations | Yes | |
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 | Yes | |
Additional Field Engineering Service | Yes | |
Number of Days | 7 | |
Justification | Installation of transmitter and supervision of antenna installation. |
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 | Yes |
Non-zoning permits | Yes | |
BLM or NFS Coordination | No | |
FCC Construction Permit Minor Change | Yes | |
FCC License to Cover Application | Yes | |
FCC Special Temporary Authority Application | Yes | |
Other Miscellaneous Expenses | Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? | Yes |
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? | Yes | |
Does this relocation require Equipment Storage? | Yes | |
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 |
Name | Description |
---|---|
Internal Labor |
Internal Labor |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $183,319.24 | $153,665.74 | N/A | $106,042.44 | N/A |
Total for all systems | $746,935.59 | $593,755.19 | N/A | $250,171.09 | N/A |
Primary Transmitter ELETXUD3600AC | $183,319.24 | $153,665.74 | $106,042.44 | ||
Primary Transmitter - Installation | $1,182.50 | $1,182.50 | Please see KRMT Primary Transmitter - Installation Budget Justification Cover Letter | $1,175.00 | N/A |
Primary Transmitter - Other Expense | $1,362.50 | $1,362.50 | Please see KRMT Primary Transmitter Other Expense Budget Revision Justification Letter | $187.50 | N/A |
Mask Filter | $8,411.50 | $8,411.50 | N/A | $6,729.20 | N/A |
Other Electrical Service: Minimal electric services will be needed to implement new facility. | $16,762.74 | $16,762.74 | Please see Estimated Cost Justification KRMT-110-1st Primary Transmitter - Other Electrical Service v0 | $16,762.74 | N/A |
UHF - Air Cooled Solid State Transmitter 2.501 - 3.999 kW | $155,600.00 | $125,946.50 | See KRMT-110-1st Primary Transmitter - UHF Air Cooled Solid State 3.6 kW Budget Increase Justification v0 | $81,188.00 | x |
Actual Information Description | File Name |
---|---|
Primary Transmitter - Installation | |
Primary Transmitter - Other Expense | |
Mask Filter | |
Other Electrical Service: Minimal electric services will be needed to implement new facility. | |
UHF - Air Cooled Solid State Transmitter 2.501 - 3.999 kW |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $43,396.58 | $43,066.58 | N/A | $30,771.58 | N/A |
Total for all systems | $746,935.59 | $593,755.19 | N/A | $250,171.09 | N/A |
Primary Antenna SWEDM8SLS/20-EP | $43,396.58 | $43,066.58 | $30,771.58 | ||
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | N/A | N/A |
UHF - High Power, Side Mount, basic slot antenna, 49 kW input, directional,, elliptically or circularly polarized | $36,666.58 | $36,666.58 | Please see KRMT-210-Primary Antenna - UHF High Power Side Mount, Directional, E-POL Estimated Cost Justification v0 | $30,771.58 | N/A |
Actual Information Description | File Name |
---|---|
Sweep test of existing antenna | Information not provided. |
UHF - High Power, Side Mount, basic slot antenna, 49 kW input, directional,, elliptically or circularly polarized |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $5,050.21 | $5,050.21 | N/A | $5,050.21 | N/A |
Total for all systems | $746,935.59 | $593,755.19 | N/A | $250,171.09 | N/A |
Primary Transmission Line | $5,050.21 | $5,050.21 | $5,050.21 | ||
Transmission Line - Other Pieces | $5,050.21 | $5,050.21 | Please see SWR quotes 17462-02 (lines 2 and 3, plus proportional shipping as described on invoice 18108) and 19632 (plus proportional shipping on invoice 18424) and RF Specialties quote P26587 | $5,050.21 | N/A |
Actual Information Description | File Name |
---|---|
Transmission Line - Other Pieces |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $268,500.00 | $195,000.00 | N/A | $250.00 | N/A |
Total for all systems | $746,935.59 | $593,755.19 | N/A | $250,171.09 | N/A |
Primary Tower TOWER | $268,500.00 | $195,000.00 | $250.00 | ||
Short Tower (less than 500') | $84,200.00 | $80,000.00 | N/A | $250.00 | N/A |
Minor tower reinforcement/modifications | $158,000.00 | $100,000.00 | N/A | N/A | N/A |
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study | $26,300.00 | $15,000.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
Short Tower (less than 500') | |
Minor tower reinforcement/modifications | Information not provided. |
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $183,915.00 | $139,442.10 | N/A | $75,768.10 | N/A |
Total for all systems | $746,935.59 | $593,755.19 | N/A | $250,171.09 | N/A |
Outside Professional Services | $183,915.00 | $139,442.10 | $75,768.10 | ||
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet | $10,520.00 | $10,000.00 | N/A | $0.00 | N/A |
NEPA Section 106 environmental review, if needed | $6,310.00 | $3,000.00 | N/A | $0.00 | N/A |
Attorney Fees - Negotiation of lease and other matters for shared locations | $4,210.00 | $2,000.00 | N/A | $1,027.50 | N/A |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $2,365.00 | $2,250.00 | N/A | $539.50 | N/A |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $5,260.00 | $5,000.00 | N/A | $0.00 | N/A |
Prepare request for Special Temporary Authorization | $2,050.00 | $1,500.00 | N/A | $0.00 | 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 | $3,000.00 | N/A | $0.00 | N/A |
Perform engineering study for new channel assignment and antenna development | $7,360.00 | $7,000.00 | N/A | $0.00 | N/A |
Address transition timing and coordination issues w/ other stations and wireless | $2,630.00 | $2,500.00 | N/A | $0.00 | N/A |
Prepare and or review reimbursement form | $2,630.00 | $2,500.00 | N/A | $509.00 | N/A |
Additional Field Engineering Service, 7 Days | $15,000.00 | $15,000.00 | N/A | $0.00 | N/A |
RF Exposure Measurements | $21,050.00 | $5,000.00 | N/A | $0.00 | N/A |
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | $2,105.00 | $2,000.00 | N/A | $0.00 | N/A |
Attorney Fees - Prepare and File request for Special Temporary Authorization | $3,680.00 | $3,500.00 | N/A | $0.00 | N/A |
Project management of the transition | $94,010.00 | $73,692.10 | The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. | $73,692.10 | N/A |
Actual Information Description | File Name |
---|---|
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet | Information not provided. |
NEPA Section 106 environmental review, if needed | Information not provided. |
Attorney Fees - Negotiation of lease and other matters for shared locations | |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | Information not provided. |
Prepare request for Special Temporary Authorization | Information not provided. |
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 | Information not provided. |
Perform engineering study for new channel assignment and antenna development | Information not provided. |
Address transition timing and coordination issues w/ other stations and wireless | Information not provided. |
Prepare and or review reimbursement form | |
Additional Field Engineering Service, 7 Days | Information not provided. |
RF Exposure Measurements | Information not provided. |
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | Information not provided. |
Attorney Fees - Prepare and File request for Special Temporary Authorization | Information not provided. |
Project management of the transition |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $62,754.56 | $57,530.56 | N/A | $32,288.76 | N/A |
Total for all systems | $746,935.59 | $593,755.19 | N/A | $250,171.09 | N/A |
Other Expenses | $62,754.56 | $57,530.56 | $32,288.76 | ||
Internal Labor | $23,554.56 | $23,554.56 | Please see KRMT Internal Labor Budget Revision Justification Letter.pdf | $23,554.25 | N/A |
Equipment Storage | $3,500.00 | $3,500.00 | N/A | $0.00 | N/A |
Disposal Costs (for equipment and other waste, net of any salvage value) | $6,510.00 | $6,510.00 | See Estimated Cost Justification KRMT-610-Disposal Costs v1 | $6,510.00 | N/A |
Develop and air announcement of upcoming channel change | $500.00 | $500.00 | N/A | $0.00 | N/A |
MVPD Notification of Channel Change | $500.00 | $500.00 | N/A | $154.51 | N/A |
DTV Medical Facility Notification | $11,550.00 | $6,381.00 | N/A | $0.00 | N/A |
FCC Filing Fees - Form 2100 minor change CP application | $1,110.00 | $1,070.00 | N/A | $0.00 | N/A |
FCC Filing Fees - Form 2100 license to cover application | $335.00 | $325.00 | N/A | $0.00 | N/A |
FCC Filing Fees - Special Temporary Authorization request | $195.00 | $190.00 | N/A | $0.00 | N/A |
Local Zoning | $5,000.00 | $5,000.00 | N/A | $0.00 | N/A |
Non-zoning permits | $5,000.00 | $5,000.00 | N/A | $0.00 | N/A |
Equipment Delivery and Handling Charges | $5,000.00 | $5,000.00 | N/A | $2,070.00 | N/A |
Actual Information Description | File Name |
---|---|
Internal Labor | |
Equipment Storage | Information not provided. |
Disposal Costs (for equipment and other waste, net of any salvage value) | |
Develop and air announcement of upcoming channel change | Information not provided. |
MVPD Notification of Channel Change | |
DTV Medical Facility Notification | Information not provided. |
FCC Filing Fees - Form 2100 minor change CP application | Information not provided. |
FCC Filing Fees - Form 2100 license to cover application | Information not provided. |
FCC Filing Fees - Special Temporary Authorization request | Information not provided. |
Local Zoning | Information not provided. |
Non-zoning permits | Information not provided. |
Equipment Delivery and Handling Charges |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $746,935.59 | $593,755.19 | $250,171.09 |
Question | Response |
---|---|
The facility has ceased operating on its pre-auction channel. | Yes |
Construction of final facilities or all necessary modifications are complete. | Yes |
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 |
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. |
|
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Arnold Torres Business Administrator 06/01/2021 |
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). |
|
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Arnold Torres Business Administrator 06/01/2021 |
Section | Question | Response |
---|---|---|
Submission of Final Allocation or Accounting Information 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. |
|
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Arnold Torres Business Administrator 06/01/2021 |