Applicant | Address | Phone | Applicant Type | |
---|---|---|---|---|
VICTORY TELEVISION NETWORK, INC. |
Jim Grant P.O. BOX 26207 LITTLE ROCK, AR 72221 United States |
+1 (501) 223-2525 | jim.grant@vtntv.com | Corporation |
Applicant | Address | Phone | |
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[Confidential] |
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Applicant | Address | Phone | |
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The Preparer is same as the reimbursement contact. |
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Question | Response |
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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 | Please see attached Transition Plan Narrative. |
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 | CST II | |
Year | 1997 | |
Type | Inductive Output Tube | |
IOT Power Type | Two | |
Power Capacity | 60 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | Yes | |
Manufacturer | ||
Model | THU9-48Evo | |
Transmitter Type | Solid State | |
Solid State Cooling | Liquid Cooled | |
Solid State Power capacity | 37 kW | |
Justification for New Transmitter | Existing transmitter manufacturer, ABS, is no longer in business. |
Section | Question | Response |
---|---|---|
Electrical Service | Service Entrance (3 phases 800A 208V) | No |
Switchgear (industrial 800 amp) | Yes | |
Transformer (480V) | No | |
Power | N/A | |
Rigid Conduit and Wiring | Yes | |
Size | 3 inches | |
Length | 200.0 feet | |
Other Electrical Service | Yes | |
Description | Electrical installation for transmitter. | |
HVAC Service | Does the replacement transmitter require HVAC Service? | Yes |
Type | Heating and Cooling | |
Size | 20 tons | |
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 |
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? | No | |
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 | 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: | 780.0 kW | |
Manufacturer | ||
Model | TFU-31JTH-R 04 | |
Year | 1998 |
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? | No | |
Will antenna be located on or in close proximity to an antenna farm? | No | |
New Antenna Manufacturer and Types | Class | Full Power |
Mounting | Top 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: | 420.0 kW | |
Manufacturer | ||
Model | TFU-22JTH-R-O4 | |
Year | 2018 | |
Justification for New Antenna | Antenna is slotted coaxial and cut to a single channel. As such, it is not retunable. |
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? | Yes |
Broadband or Single Channel? | Single Channel | |
Feed Line Size | 6 1/8 inches inches | |
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 |
---|---|---|
New Antenna Description | Use | Interim |
Description of Use | N/A | |
Change Type | Purchase New | |
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 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/Bays | N/A | |
Lower Limit | N/A | |
Upper Limit | N/A | |
Design power capacity in use | N/A | |
Other Antenna Type | N/A | |
ERP: | 780.0 kW | |
Manufacturer | ||
Model | TFU-24WB-1-R S230 | |
Year | 2018 | |
Justification for New Antenna | Interim antenna to operate lower on the tower for the pre-auction channel to avoid prolonged off-period during the transition in order to meet the construction deadline. |
Section | Question | Response |
---|---|---|
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 an antenna? | No |
Pattern Scatter Analysis | Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? | Yes |
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 | Dielectric |
Type | Rigid | |
Diameter | 6 1/8 inches | |
Other Diameter | N/A | |
Segment Length | 20 inches | |
Other Segment Length | N/A | |
Number of parallel runs | 1 | |
Length | 1090 feet per run |
Section | Question | Response |
---|---|---|
New Transmission Line Costs | Use | Interim |
Description of Use | N/A | |
Change Type | Purchase New | |
Type | Flexible Air | |
Diameter | 5 inches | |
Segment Length | N/A | |
Other Segment Length | ||
Number of parallel runs | 1 | |
Length | 950 feet per run | |
Justification for New Transmission Line | Interim transmission line to operate lower on the tower for the pre-auction channel to avoid prolonged off-period during the transition in order to meet the construction deadline. |
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 | 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? | Yes | |
Is tower compliant with Rev G? | No | |
Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
ASR Number | 1048797 | |
Coordinates (NAD83) | Latitude (NAD83) | 35° 36' 16.0" N- |
Longitude (NAD83) | 090° 31' 18.0" W- | |
Overall Structure Height | 999.99 feet | |
Support Structure Height | 999.99 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 215.88 feet | |
Structure Type | TOWER - Free Standing or Guyed Structure | |
Tower Owner | Victory Television Network, Inc. | |
Date Constructed | 04/20/1998 |
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: | Serious Reinforcements needed |
Section | Question | Response |
---|---|---|
Tower Rigging Costs | Complex Tower | N/A |
Helicopter Services Required | Are helicopter services required? | No |
Name | Description |
---|---|
Interim Installation |
Install interim antenna and transmission line. |
Section | Question | Response |
---|---|---|
Outside Project Management Services | Do you require outside project management services? | Yes |
Number of Hours | 350 | |
Explanation | Please see the attached Transition Plan Narrative. | |
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 | No | |
Environmental Assessment | No | |
ASR Modification | Yes | |
FAA Consultation (including preparation of FAA Form 7460) | Yes | |
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 | No | |
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 |
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 | 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? | No | |
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? | No | |
Does this relocation require MVPD Notification of a Channel Change? | Yes |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $1,662,100.00 | $1,581,100.00 | N/A | $276,487.23 | N/A |
Total for all systems | $3,918,150.00 | $3,742,135.00 | N/A | $1,069,730.24 | N/A |
Primary Transmitter THU9-48Evo | $1,662,100.00 | $1,581,100.00 | $276,487.23 | ||
Other Electrical Service: Electrical installation for transmitter. | $25,000.00 | $25,000.00 | Electrical installation for the transmitter. | N/A | N/A |
3" Rigid Conduit and Wiring (Cost per foot) | $10,400.00 | $9,800.00 | 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 35 - 50 kW | $1,473,000.00 | $1,400,000.00 | N/A | $276,487.23 | N/A |
20 Ton system | $115,500.00 | $110,000.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
Other Electrical Service: Electrical installation for transmitter. | Information not provided. |
3" Rigid Conduit and Wiring (Cost per foot) | Information not provided. |
Switchgear - industrial 800 amp | Information not provided. |
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW | |
20 Ton system | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $500,520.00 | $479,500.00 | N/A | $161,285.18 | N/A |
Total for all systems | $3,918,150.00 | $3,742,135.00 | N/A | $1,069,730.24 | N/A |
Interim Antenna TFU-24WB-1-R S230 | $191,990.00 | $186,400.00 | $80,065.58 | ||
UHF - High Power, Side Mount, basic slot antenna, 780 kW input, directional,, horizontally polarized | $180,000.00 | $180,000.00 | Catalog estimated cost for UHF-Lower Power Side Mount: One station - 200-500kW, horizontally polarized | $77,185.58 | N/A |
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | $2,880.00 | N/A |
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) | $5,260.00 | $0.00 | The interim scatter study cost will now be bundled into the interim antenna cost component. | N/A | N/A |
Primary Antenna TFU-22JTH-R-O4 | $308,530.00 | $293,100.00 | $81,219.60 | ||
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized | $289,500.00 | $275,000.00 | N/A | $78,339.60 | N/A |
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | $2,880.00 | N/A |
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) | $12,300.00 | $11,700.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
UHF - High Power, Side Mount, basic slot antenna, 780 kW input, directional,, horizontally polarized | |
Sweep test of existing antenna | |
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) | Information not provided. |
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized | |
Sweep test of existing antenna | |
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $99,750.00 | $95,000.00 | N/A | $30,484.83 | N/A |
Total for all systems | $3,918,150.00 | $3,742,135.00 | N/A | $1,069,730.24 | N/A |
Interim Transmission Line | $99,750.00 | $95,000.00 | $30,484.83 | ||
Flexible Air Transmission Line - dielectric, 5" | $99,750.00 | $95,000.00 | N/A | $30,484.83 | N/A |
Primary Transmission Line | $0.00 | $0.00 | $0.00 |
Actual Information Description | File Name |
---|---|
Flexible Air Transmission Line - dielectric, 5" |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $1,488,800.00 | $1,425,000.00 | N/A | $570,332.00 | N/A |
Total for all systems | $3,918,150.00 | $3,742,135.00 | N/A | $1,069,730.24 | N/A |
Primary Tower TOWER | $1,488,800.00 | $1,425,000.00 | $570,332.00 | ||
Interim Installation | $200,000.00 | $200,000.00 | N/A | $48,174.00 | N/A |
Tall Tower (greater than 500') | $210,500.00 | $200,000.00 | Main antenna installation. | $77,182.00 | N/A |
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study | $26,300.00 | $25,000.00 | N/A | $1,400.00 | N/A |
Serious tower reinforcement/modifications | $1,052,000.00 | $1,000,000.00 | Please see the attached Transition Plan Narrative and Structural Analysis. | $443,576.00 | N/A |
Actual Information Description | File Name |
---|---|
Interim Installation | |
Tall Tower (greater than 500') | |
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study | |
Serious tower reinforcement/modifications |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $87,590.00 | $82,750.00 | N/A | $17,838.00 | N/A |
Total for all systems | $3,918,150.00 | $3,742,135.00 | N/A | $1,069,730.24 | N/A |
Outside Professional Services | $87,590.00 | $82,750.00 | $17,838.00 | ||
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 | N/A | N/A |
ASR modification (prepare FCC Form 854) | $2,105.00 | $2,000.00 | N/A | N/A | N/A |
Attorney Fees - Prepare and File request for Special Temporary Authorization | $3,680.00 | $3,500.00 | 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 |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $5,260.00 | $5,000.00 | N/A | $4,988.00 | N/A |
Prepare request for Special Temporary Authorization | $2,050.00 | $1,500.00 | N/A | $600.00 | 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 | $2,250.00 | N/A |
Project management of the transition | $55,300.00 | $52,500.00 | N/A | $3,000.00 | N/A |
Prepare and or review reimbursement form | $2,630.00 | $2,500.00 | N/A | $2,500.00 | N/A |
Perform engineering study for new channel assignment and antenna development | $7,360.00 | $7,000.00 | N/A | $4,500.00 | N/A |
Actual Information Description | File Name |
---|---|
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | Information not provided. |
ASR modification (prepare FCC Form 854) | Information not provided. |
Attorney Fees - Prepare and File request for Special Temporary Authorization | Information not provided. |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | Information not provided. |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | |
Prepare request for Special Temporary Authorization | |
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 | |
Project management of the transition | |
Prepare and or review reimbursement form | |
Perform engineering study for new channel assignment and antenna development |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $79,390.00 | $78,785.00 | N/A | $13,303.00 | N/A |
Total for all systems | $3,918,150.00 | $3,742,135.00 | N/A | $1,069,730.24 | N/A |
Other Expenses | $79,390.00 | $78,785.00 | $13,303.00 | ||
DTV Medical Facility Notification | $11,550.00 | $11,000.00 | N/A | N/A | N/A |
FCC Filing Fees - Form 2100 minor change CP application | $1,110.00 | $1,070.00 | 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 |
FCC Filing Fees - Special Temporary Authorization request | $195.00 | $190.00 | N/A | N/A | N/A |
Disposal Costs (for equipment and other waste, net of any salvage value) | $25,000.00 | $25,000.00 | Disposal of antenna, transmitter, RF system | N/A | N/A |
Equipment Delivery and Handling Charges | $40,000.00 | $40,000.00 | Shipping for main and interim antennas and interim transmission line. We now know that actual costs for delivery will be higher than originally estimated. | $13,303.00 | N/A |
MVPD Notification of Channel Change | $1,200.00 | $1,200.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
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. |
Disposal Costs (for equipment and other waste, net of any salvage value) | Information not provided. |
Equipment Delivery and Handling Charges | |
MVPD Notification of Channel Change | Information not provided. |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $3,918,150.00 | $3,742,135.00 | $1,069,730.24 |
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 |
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. | Jim Grant General Manager 01/26/2018 |
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. | Jim Grant General Manager 01/26/2018 |