Go to the Federal Communications Commission homepage at www.fcc.gov

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:
24618
Service:
DTV
Call Sign:
WGNM
Channel:
33 (UHF)
File Number:
0000027788
FRN:
0010360873
Date Submitted:
08/05/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

CHRISTIAN TELEVISION NETWORK, INC.

Doing Business As: CHRISTIAN TELEVISION NETWORK, INC.

P.O. Box 6922

Clearwater, FL 33758

United States

+1 (727) 535-5622 soneal@ctntv.net Not-for-Profit

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

Joseph C. Chautin III

Hardy, Carey, Chautin & Balkin LLP

1080 West Causeway Approach

Mandeville, LA 70471

United States

+1 (985) 629-0777 jchautin@hardycarey.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 WGNM will install temp low power antenna & line. Existing xmtr will feed temp LP antenna thru mask filter. Removal of old antenna & transmission line. Then, installation of new antenna, new transmission line, mask filter and transmitter to begin

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 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 Visionary
Year 2004
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 24 kW

Primary Transmitter

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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 Parallax
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 27.5 kW
Justification for New Transmitter Manufacturer (Axcera) no longer in business. Existing transmitter not supported. Also, please see attached justification regarding replacement transmitter and TPO.

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 Yes
Description additional breakers in panel, EMT or flexible metal conduit, misc wiring
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

Name Description

anti-freeze

coolant anti-freeze

transmission line

transmitter building interior transmission line components for transmitter interconnects

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 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: 1000.0 kW
Manufacturer
Model PSIUSMD24AC3-45
Year 2004

Primary Antenna

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New Antenna Costs

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? No
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 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: 793.0 kW
Manufacturer
Model TFU-24DSC-R C200
Year 2017
Justification for New Antenna Existing antenna cannot be re-channeled.

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 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

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

temporary antenna

A temporary low power antenna & line will be needed during the re-channeling process to keep WGNM on the air.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
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
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 720 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 720 feet per run
Justification for New Transmission Line The rigid transmission line section size recommended by Dielectric is 19.5' for channel 33. WGNM's existing transmission line is Myat line and Myat also recommends 19.5' sections (see DIE and Myat quotes). Applicant requests manufacturer recommended sizes

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Temporary transmission line

1 5/8" Heliax needed to feed temporary antenna which will keep WGNM on the air during modification of facility

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 Move Equipment
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? 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? Yes
ASR Number 1045776
Coordinates (NAD83) Latitude (NAD83) 32° 45' 52.0" N-
Longitude (NAD83) 083° 33' 32.0" W-
Overall Structure Height 636.48 feet
Support Structure Height 629.91 feet
Ground Elevation Above Mean Sea Level (AMSL) 495.07 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner T-Mobile South LLC
Date Constructed 06/02/1999


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

Information not provided.

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 605
Explanation Project management (Invoice processing, progress reporting, daisy chain monitoring and analysis, program management, and site visits as required)
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 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 No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 2
Justification optimization of new transmission line to operated on new channel

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Attorney - 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 No
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? 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 $959,200.00 $870,817.00 N/A $0.00 N/A
Total for all systems $1,714,303.20 $1,593,326.55 N/A $32,225.25 N/A
Primary Transmitter Parallax $959,200.00 $870,817.00 $0.00
anti-freeze $200.00 $200.00 needed coolant for heat exchanger N/A N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $858,617.00 N/A N/A N/A
Other Electrical Service: additional breakers in panel, EMT or flexible metal conduit, misc wiring $7,000.00 $7,000.00 interconnect needed from existing electrical service to new transmitter components N/A N/A
transmission line $5,000.00 $5,000.00 interconnect transmission line components within transmitter building N/A N/A

Components

Information not provided.

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 $207,146.20 $206,816.20 N/A $0.00 N/A
Total for all systems $1,714,303.20 $1,593,326.55 N/A $32,225.25 N/A
Primary Antenna TFU-24DSC-R C200 $207,146.20 $206,816.20 $0.00
temporary antenna $20,925.00 $20,925.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 Please note that the sweep test is not for the existing antenna, but instead for the new antenna (see line 24 of the attached antenna quote). The Form 399 question only asks whether a sweep test is needed; the description then adds "existing antenna" N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 793 kW input, directional,, horizontally polarized $179,491.20 $179,491.20 N/A N/A N/A

Components

Information not provided.

Cost Information

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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 $164,440.00 $140,976.35 N/A $0.00 N/A
Total for all systems $1,714,303.20 $1,593,326.55 N/A $32,225.25 N/A
Primary Transmission Line $164,440.00 $140,976.35 $0.00
Temporary transmission line $19,000.00 $19,000.00 N/A N/A N/A
Rigid Transmission Line - copper, 6 1/8" $145,440.00 $121,976.35 N/A N/A N/A

Components

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 $210,500.00 $200,000.00 N/A $0.00 N/A
Total for all systems $1,714,303.20 $1,593,326.55 N/A $32,225.25 N/A
Primary Tower TOWER $210,500.00 $200,000.00 $0.00
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A N/A N/A

Components

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 $128,372.00 $130,627.00 N/A $32,225.25 N/A
Total for all systems $1,714,303.20 $1,593,326.55 N/A $32,225.25 N/A
Outside Professional Services $128,372.00 $130,627.00 $32,225.25
Project management of the transition $95,590.00 $99,675.00 Justifying Quote - WGNM Strategic support quote $27,602.75 N/A
Additional Field Engineering Service, 2 Days $4,000.00 $4,000.00 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 $550.00 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 N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,000.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $562.50 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $808.00 N/A
Attorney - Other Matters $702.00 $702.00 Please see WGNM Justification Outside Professional Services-Attorney-Other Matters $702.00 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Project Management
Amount:
$2,696.10

Component Description:
Project Management
Amount:
$2,220.40

Component Description:
Project Management
Amount:
$1,120.70

Component Description:
Project Management
Amount:
$2,643.80

Component Description:
Project Management
Amount:
$1,682.70

Component Description:
Project Management
Amount:
$1,407.05

Component Description:
Project Management
Amount:
$1,803.40

Component Description:
Project Management
Amount:
$1,660.70

Component Description:
Project Management
Amount:
$1,505.60

Component Description:
Project Management
Amount:
$1,508.10

Component Description:
Project Management
Amount:
$1,564.60

Component Description:
Project Management
Amount:
$1,575.90

Component Description:
Project Management
Amount:
$1,231.60

Component Description:
Project Management
Amount:
$1,607.40

Component Description:
Project Management
Amount:
$1,023.10

Component Description:
Project Management
Amount:
$2,351.60
Additional Field Engineering Service, 2 Days 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

Component Description:
WGNM-550-Attorney - Construction Permit Application (Main) to process line item 5/15/17
Amount:
$80.00

Component Description:
Load and prepare initial draft Form 2100 for repacked channel construction permit application.
Amount:
$80.00

Component Description:
Review, modify and finalize Form 2100 CP application for WGNM
Amount:
$390.00
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

Component Description:
WGNM-530-RF Eng - Construction Permit Application (Main)
Amount:
$2,000.00
Perform engineering study for new channel assignment and antenna development

Component Description:
1. Engineering study work for new channel assignment and antenna development.
Amount:
$250.00

Component Description:
Engineering study work for new channel assignment and antenna development.
Amount:
$312.50
Prepare and or review reimbursement form

Component Description:
Review notice of WGNM repack CP grant
Amount:
$260.00

Component Description:
Draft Form 399 on LMS.
Amount:
$80.00

Component Description:
Review FCC request to associate username with WGNM FRN
Amount:
$468.00
Attorney - Other Matters

Component Description:
Attempt to complete WGNM quarterly transition report
Amount:
$78.00

Component Description:
WGNM-550-Attorney - Other Matters
Amount:
$468.00

Component Description:
WGNM-550-Attorney - Other Matters
Amount:
$156.00

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 $44,645.00 $44,090.00 N/A $0.00 N/A
Total for all systems $1,714,303.20 $1,593,326.55 N/A $32,225.25 N/A
Other Expenses $44,645.00 $44,090.00 $0.00
MVPD Notification of Channel Change $1,500.00 $1,500.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $400.00 $400.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $6,000.00 $6,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 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 $1,714,303.20 $1,593,326.55 $32,225.25

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.

CHRIS L MAVROS

D.E., Christian Television Network


08/05/2019

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.

CHRIS L MAVROS

D.E., Christian Television Network


08/05/2019

Attachments

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