TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
MISSION BROADCASTING, INC.	901 Indiana Avenue Suite 375 Wichita Falls, TX 76301 United States	+1 (940) 228-7861	missionbroadcasting@gmail.com	Corporation

Applicant

Address

Phone

Applicant Type

MISSION BROADCASTING, INC.

901 Indiana Avenue

Suite 375

Wichita Falls, TX 76301

United States

+1 (940) 228-7861

missionbroadcasting@gmail.com

Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Gregory L. Masters , Esq . FCC Counsel Wiley Rein LLP	1776 K Street, N.W. Washington, DC 20006 United States	+1 (202) 719-7370	gmasters@wiley.law

Applicant

Address

Phone

Gregory L. Masters , Esq .

FCC Counsel

Wiley Rein LLP

1776 K Street, N.W.

Washington, DC 20006

United States

+1 (202) 719-7370

gmasters@wiley.law

Broadcaster Information and Transition Plan

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.	Yes
Briefly describe transition plan	Replace transmitter using existing antenna and line. See attachment.

Question	Response
Sharee Station Facility ID	40743
Call Sign	K38IM
Type
Licensee Name	EDGE SPECTRUM, INC.
Status	LICENSED AND SILENT
DTS	No
Community of License	ALBUQUERQUE, NM
Pre-auction RF Channel	38
Post-auction RF Channel
Neilsen DMA
Network Affiliation

Question	Response
Sharee Station Facility ID	32311
Call Sign	KASA-TV
Type	Commercial
Licensee Name	RAMAR COMMUNICATIONS, INC.
Status	LICENSED
DTS	No
Community of License	SANTA FE, NM
Pre-auction RF Channel	27
Post-auction RF Channel	27
Neilsen DMA	Albuquerque-Santa Fe
Network Affiliation

Question	Response
Sharee Station Facility ID	76268
Call Sign	KWBQ
Type	Commercial
Licensee Name	Mission Broadcasting, Inc.
Status	LICENSED
DTS	No
Community of License	SANTA FE, NM
Pre-auction RF Channel	29
Post-auction RF Channel	29
Neilsen DMA	Albuquerque-Santa Fe
Network Affiliation

Question	Response
Sharee Station Facility ID	55528
Call Sign	KNME-TV
Type	Noncommercial Educational
Licensee Name	REGENTS/UNIVERSITY OF NEW MEXICO & BOARD OF EDUCATION/ALBQ.,
Status	LICENSED
DTS	No
Community of License	ALBUQUERQUE, NM
Pre-auction RF Channel	35
Post-auction RF Channel	35
Neilsen DMA	ALBUQUERQUE-SANTA FE
Network Affiliation

Transmitters

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

Primary Transmitter

Existing Transmitter Information

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	CTT-U-DCX-1H
	Year	2002
	Type	Inductive Output Tube
	IOT Power Type	Single
	Power Capacity	20 kW

Primary Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Primary (Main)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	Yes
	Manufacturer
	Model	THU9EVO-16
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	25.5 kW
	Justification for New Transmitter	The manufacturer of the existing IOT transmitter advises that the transmitter cannot be re-tuned to the assigned channel. See attached quotes. Request is for a SS one power step up from the required TPO.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	Yes
	Power	150 kVA
	Rigid Conduit and Wiring	Yes
	Size	3 inches
	Length	100.0 feet
	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

Other Transmitter Cost Not Listed

Name	Description
Transmitter Electrical Work	Transmitter electrical work
Additional Transmitter Costs	Additional Transmitter Costs

Antennas

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

Primary Antenna

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?	Yes
	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	Top Mount
	Antenna position in stack	Top
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	2
	Number of Panels	40
	Design power capacity in use	100.0 %
	Lower Limit	470.00 MHz
	Upper Limit	692.00 MHz
	Other Antenna Type	N/A
	ERP:	245.0 kW
	Manufacturer	Dielectric
	Model	TUD-05-8/40H-T
	Year	2007

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID	Call Sign
55528	KNME-TV

Primary Antenna

Adjustment to Existing Antenna

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

Primary Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	Yes
	Type	New
	Number of channels supported	2
	Frequencies of channels supported	RF channel
	Frequency	N/A

Enter a list of RF channel numbers.

RF Channel Number
35
36

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Rigging	Rigging for sweep tests and possible elbow complex replacement

Transmission Line

Section	Question	Response
Transmission Line Related Expenses	Do you have transmission line related expenses?	Yes

Primary Transmission Line

Existing Transmission Line

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	Dielectric
	Type	Rigid
	Diameter	7 3/16 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	290 feet per run

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Sweep Tests	Sweep tests for transmission line
Connect to new combiner	Misc line sections to connect to new combiner

Tower Equipment And Rigging Costs

Section	Question	Response
Tower Equipment or Rigging Costs Changes	Do you have tower equipment or rigging costs changes?	No

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	173
	Explanation	It will be necessary to schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. Station does not have available personnel or personnel trained in project management for such complex projects.
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	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	No
	Additional Field Engineering Service	Yes
	Number of Days	9
	Justification	It will be necessary to survey the site, plan the equipment, develop specifications for purchasing, and oversee multiple vendor RF projects. Station does not have available personnel or personnel trained in such services.

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
American Tower Services	Engineering and management fees from American Tower. KASY share only.
Minor Modification of CP Application	Minor Modification of CP Application
License to Cover Application	License to Cover Application

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	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	Yes
	BLM or NFS Coordination	No
	FCC Construction Permit Minor Change	No
	FCC License to Cover Application	No
	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)?	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

Other Expenses

Other Expenses Not Listed

Name	Description
Sales Tax	Sales tax on goods and service

Cost Information

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	$1,063,767.00	$781,867.00	N/A	$716,367.00	N/A
Total for all systems	$1,506,641.72	$1,227,005.72	N/A	$1,085,254.48	N/A
Primary Transmitter THU9EVO-16	$1,063,767.00	$781,867.00		$716,367.00
Additional Transmitter Costs	$5,317.00	$5,317.00	See Rohde & Schwarz quote 202174.1 and 182814.0	$5,317.00	N/A
Transmitter Electrical Work	$42,500.00	$42,500.00	See Rohde & Schwarz quote 178932.0	$42,500.00	N/A
3" Rigid Conduit and Wiring (Cost per foot)	$5,200.00	$4,900.00	N/A	N/A	N/A
Transformer 3 phase/480v - 150 KVA	$25,550.00	$24,300.00	N/A	N/A	N/A
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	N/A	N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	$947,000.00	$668,550.00	See Rohde & Schwarz quote 137498.2 attached.	$668,550.00	N/A

Components

Actual Information Description	File Name
Additional Transmitter Costs	Component Description: Additional transmitter components Amount: $3,717.00 Component Description: Additional transmitter costs Amount: $1,600.00
Transmitter Electrical Work	Component Description: Transmitter electrical work Amount: $42,500.00
3" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Transformer 3 phase/480v - 150 KVA	Information not provided.
Switchgear - industrial 800 amp	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	Component Description: Transmitter, installment #2 Amount: $501,412.50 Component Description: Transmitter, installment #1 Amount: $167,137.50

Cost Information

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	$126,402.18	$140,048.18	N/A	$138,648.18	N/A
Total for all systems	$1,506,641.72	$1,227,005.72	N/A	$1,085,254.48	N/A
Primary Antenna TUD-05-8/40H-T	$126,402.18	$140,048.18		$138,648.18
Rigging	$27,872.18	$27,872.18	KASY share of costs to install new combiner based on quote from American Tower.	$27,872.18	N/A
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed)	$7,600.00	$6,790.00	See Dielectric order confirmation 1749120	$6,790.00	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$98,986.00	Quote from American Tower for KASY's share of new combiner expenses.	$98,986.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$5,000.00	N/A

Components

Actual Information Description	File Name
Rigging	Component Description: KASY Share of combiner installation and materials Amount: $27,872.18
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed)	Component Description: Elbow components Amount: $6,790.00
New combiner, cost per channel (without antenna)	Component Description: KASY share of combiner cost Amount: $98,986.00
Sweep test of existing antenna	Component Description: Sweep test Amount: $5,000.00

Cost Information

Transmission Line

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	$20,346.54	$20,346.54	N/A	$18,946.54	N/A
Total for all systems	$1,506,641.72	$1,227,005.72	N/A	$1,085,254.48	N/A
Primary Transmission Line	$20,346.54	$20,346.54		$18,946.54
Connect to new combiner	$13,946.54	$13,946.54	Tx line costs to connect to new combiner.	$13,946.54	N/A
Sweep Tests	$6,400.00	$6,400.00	N/A	$5,000.00	N/A

Components

Actual Information Description	File Name
Connect to new combiner	Component Description: Combiner interconnect parts Amount: $13,946.54
Sweep Tests	Component Description: Sweep test Amount: $5,000.00

Cost Information

Tower Equipment and Rigging Costs

Information not provided.

Cost Information

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	$102,129.00	$99,305.00	N/A	$58,818.50	N/A
Total for all systems	$1,506,641.72	$1,227,005.72	N/A	$1,085,254.48	N/A
Outside Professional Services	$102,129.00	$99,305.00		$58,818.50
License to Cover Application	$625.00	$625.00	Prepare engineering portion of a License to Cover a Post-Transition CP Application; see Osborn invoice 34505	$625.00	N/A
Additional Field Engineering Service, 9 Days	$18,000.00	$18,000.00	N/A	N/A	N/A
Minor Modification of CP Application	$2,500.00	$2,500.00	See Osborn invoice 34505; required due to request from American Tower to change antenna model from upper stack to lower stack.	$2,500.00	N/A
American Tower Services	$24,480.00	$24,480.00	KASY share of costs for American Tower services: engineering, permitting, project management. Based on American Tower Quote attached.	$24,480.00	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$4,000.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$3,000.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$7,000.00	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	$2,500.00	N/A
Project management of the transition	$27,334.00	$25,950.00	N/A	$18,713.50	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
License to Cover Application	Component Description: License to Cover application Amount: $625.00
Additional Field Engineering Service, 9 Days	Information not provided.
Minor Modification of CP Application	Component Description: Prepare engineering portion of minor modification of CP application Amount: $2,500.00
American Tower Services	Component Description: Engineering and management fees Amount: $24,480.00
Attorney Fees - Negotiation of lease and other matters for shared locations	Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	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	Component Description: See cover letter item 4 - Prepare FCC Form 2100 construction permit application Including invoice from contractor Kessler and Gehman Associates. Amount: $3,000.00
Perform engineering study for new channel assignment and antenna development	Component Description: See cover letter item 3 - Perform engineering study for new channel assignment and antenna development. Including invoice from contractor Kessler and Gehman Associates. Amount: $7,000.00
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: See cover letter item 2 - Prep and review FCC form 399. Including invoice from contractor Kessler and Gehman Associates. Amount: $2,500.00
Project management of the transition	Component Description: Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from September 29, 2018 through October 26, 2018. Amount: $300.00 Component Description: Project management services Amount: $4,272.50 Component Description: Project management services February 2019 Amount: $123.50 Component Description: Project management services March 2019 Amount: $71.50 Component Description: Project management services 4.27.19 through 5.31.19 Amount: $150.00 Component Description: Project management services April 2019 Amount: $78.00 Component Description: Project management services January 2019 Amount: $65.00 Component Description: Project management services Amount: $50.00 Component Description: See cover letter items 1, 5-8: Project Management for Structural Analysis and Tower Modifications and progress reporting including from constractor Kessler and Gehman Associates. Amount: $10,203.00 Component Description: Project management services 2.1.19 through 3.1.19 Amount: $225.00 Component Description: Project Management for Structural Analysis and Tower Modifications from October 27, 2018 through November 30, 2018. Invoice from consultants Kessler and Gehman Associates also included. Amount: $875.00 Component Description: Project Management for Structural Analysis and Tower Modifications including Kessler and Gehman Associates. Services from May 26, 2018 through June 29, 2018 Amount: $600.00 Component Description: Project Management for Structural Analysis and Tower Modifications. Services from December 1, 2018 through December 31, 2018. Amount: $150.00 Component Description: Project management services 3.30.19 through 4.26.19 Amount: $300.00 Component Description: Project management services 10.18 Amount: $50.00 Component Description: Project management services 6.1.19 through 6.28.19 Amount: $450.00 Component Description: Project Management for Structural Analysis and Tower Modifications including Kessler and Gehman Associates. Services from January 1, 2019 through January 31, 2019 for Form 387 Transition Plan Progress Report 2018 Q4 preparation Amount: $150.00 Component Description: Project Management for Structural Analysis and Tower Modifications. Services from June 30, 2018 through July 27, 2018. Amount: $225.00 Component Description: Project management services 3.2.19 through 3.29.19 Amount: $225.00 Component Description: Project Management for Structural Analysis and Tower Modifications. Services from July 28, 2018 through September 28, 2018. Amount: $150.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Information not provided.

Cost Information

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	$193,997.00	$185,439.00	N/A	$152,474.26	N/A
Total for all systems	$1,506,641.72	$1,227,005.72	N/A	$1,085,254.48	N/A
Other Expenses	$193,997.00	$185,439.00		$152,474.26
Sales Tax	$66,000.00	$66,000.00	Sales tax for goods and services based on NM tax rate of 5.125% plus county tax. See related invoices.	$65,535.69	N/A
MVPD Notification of Channel Change	$2,000.00	$2,000.00	N/A	N/A	N/A
Develop and air announcement of upcoming channel change	$3,500.00	$3,500.00	Costs to produce spots and crawls for viewer notification.	N/A	N/A
Equipment Storage	$25,000.00	$25,000.00	N/A	N/A	N/A
Equipment Delivery and Handling Charges	$33,997.00	$33,997.00	See Rohde & Schwarz quotes 169822.0, 185625.0, 222485.0 and Dielectric order confirmation 1749120	$33,996.57	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$49,950.00	$49,950.00	See USA Commercial and Jaytec quotes attached.	$49,950.00	N/A
Non-zoning permits	$2,000.00	$2,000.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$2,992.00	See DTVNotification EST-000892	$2,992.00	N/A

Components

Actual Information Description	File Name
Sales Tax	Component Description: Tax on transmitter equipment delivery Amount: $214.74 Component Description: KASY Sales and Use Tax Amount: $12,199.00 Component Description: Tax on additional transmitter components Amount: $190.50 Component Description: Tax due on transmitter Amount: $34,263.19 Component Description: Tax due on mountain delivery Amount: $636.01 Component Description: Tax on additional transmitter costs Amount: $82.00 Component Description: Tax on transmitter disposal services Amount: $3,146.06 Component Description: Tax due on transmitter electrical work Amount: $2,178.13 Component Description: Tax on transportation/consolidation services Amount: $1,342.11 Component Description: Tax on American Tower services Amount: $11,283.95
MVPD Notification of Channel Change	Information not provided.
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Information not provided.
Equipment Delivery and Handling Charges	Component Description: Elbow components shipping cost Amount: $1,128.57 Component Description: Transmitter transportation/consolidation services Amount: $16,268.00 Component Description: Transmitter equipment delivery costs Amount: $4,190.00 Component Description: Mountain delivery services Amount: $12,410.00
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: Disposal costs Amount: $10,000.00 Component Description: Transmitter disposal costs Amount: $39,950.00
Non-zoning permits	Information not provided.
DTV Medical Facility Notification	Component Description: Notification of Medical Facilities Amount: $2,992.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$1,506,641.72	$1,227,005.72	$1,085,254.48

Reimbursement Status

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.	Yes

Certification

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.
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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Dennis P. Thatcher President 10/08/2021

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.

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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Dennis P. Thatcher

President

10/08/2021

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

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Primary Antenna

Adjustment to Existing Antenna

Primary Antenna

Other Antenna Costs

Enter a list of RF channel numbers.

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components

Cost Information

Grand Total

Reimbursement Status

Certification

Attachments