Applicant | Address | Phone | Applicant Type | |
---|---|---|---|---|
Tucson TV License Company, LLC |
Jeffrey W. Mayes 1925 Century Park East 10th Floor Los Angeles, CA 90067 United States |
+1 (310) 277-3500 | JeffreyM@es.tv | Limited Liability Company |
Applicant | Address | Phone | |
---|---|---|---|
[Confidential] |
|
|
|
Applicant | Address | Phone | |
---|---|---|---|
Tony zumMallen President QCommunications, LLC |
Tony zumMallen 705B SE Melody LN #314 Lee's Summit, MO 64063 United States |
+1 (816) 729-1177 | tony@qcomm.tv |
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 | Replace the transmitter, line and antenna per the channel reassignment with reasonable and customary engineering and business practices. |
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) | |
Ownership | Owned | |
Is this transmitter currently shared with another station? | No | |
Is this transmitter currently in operating condition? | Yes | |
Existing Transmitter Manufacturer and Type | Manufacturer | |
Model | 832A | |
Year | 2000 | |
Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power Capacity | 1 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | No | |
Manufacturer | ||
Model | UAXTE-2R37 | |
Transmitter Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power capacity | 1 kW | |
Justification for New Transmitter | New transmitter required for new channel. |
Section | Question | Response |
---|---|---|
Other Transmitter Costs | ||
Does the transmitter installation require a Transmitter Building Site Survey/Installation? | Yes | |
Electrical Service | Service Entrance (3 phases 800A 208V) | No |
Switchgear (industrial 800 amp) | No | |
Transformer (480V) | No | |
Rigid Conduit and Wiring | No | |
Other Electrical Service | No | |
HVAC Service | Does the replacement transmitter require HVAC Service? | No |
Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | No |
Name | Description |
---|---|
Power Supply |
Power Supply |
Switch |
Cisco 350 Series SG350-20 Switch |
Transmitter Shipping fee |
Shipping costs for transmitter |
Decoder |
Sencore SD 4:2:0 SDI/Discrete Video Decode Module |
Site Prep |
Preparation of site for new transmitter |
Transmitter Taxes |
Sales tax for new transmitter |
Decommissioning |
Harvesting and removal of original transmitter |
Spares, adapters, cable assemblies, etc. |
Misc parts required to connect new transmitter to existing system |
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) | |
Ownership | Owned | |
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? | Yes | |
Existing Antenna Manufacturer and Type | ||
Mounting | Side Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Horizontal | |
Type | Slotted Coaxial | |
ERP: | 42.0 kW | |
Manufacturer | ||
Model | ATC-BCH710CNS-20 | |
Year | 2013 |
Section | Question | Response |
---|---|---|
New Antenna Description | Use | Primary (Main) |
Change Type | Purchase New | |
Ownership | Owned | |
Is antenna shared? | No | |
Is antenna directional? | Yes | |
Will antenna be located on or in close proximity to an antenna farm? | Yes | |
New Antenna Manufacturer and Types | ||
Mounting | Side Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Elliptical | |
Type | Slotted Coaxial | |
ERP: | 15.0 kW | |
Manufacturer | ||
Model | ATC-BCE414C2-V4-28 | |
Year | 2019 | |
Justification for New Antenna | New antenna required for new channel. |
Section | Question | Response |
---|---|---|
Elbow Complex | Do you require the separate purchase of the Elbow Complex? | No |
Side Mount Brackets | Do you require the separate purchase of side mount brackets for a high power antenna? | Yes |
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 |
Name | Description |
---|---|
Antenna Sales Tax |
Sales tax for antenna |
Antenna Shipping fee |
Shipping fees for antenna |
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 | Purchase New |
Use | Primary (Main) | |
Ownership | Owned | |
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 | Flexible Foam | |
Diameter | 7/8 inches | |
Number of parallel runs | 1 | |
Length | 38 feet per run |
Section | Question | Response |
---|---|---|
New Transmission Line Costs | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | No | |
Type | Flexible Foam | |
Diameter | 7/8 inches | |
Number of parallel runs | 1 | |
Length | 100 feet per run | |
Justification for New Transmission Line | New line needed to mate new antenna and new transmitter. | |
Interior RF Systems | Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? | No |
Name | Description |
---|---|
Transmission line shipping |
Shipping fees for new line |
Transmission line taxes |
Sales tax for transmission line |
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) | |
Ownership | Owned | |
Is this tower consider Complex? | No | |
Is this tower currently shared with any other stations? | No | |
Is tower documented for structural analysis? | Yes | |
Is tower compliant with Rev G? | Unknown | |
Existing Tower Structure Registration | Do you have a tower registration number? | No |
Coordinates (NAD83) | Latitude (NAD83) | 31° 28' 54.2" N- |
Longitude (NAD83) | 109° 57' 35.0" W- | |
Overall Structure Height | 63.00 feet | |
Support Structure Height | 60.00 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 7120.00 feet | |
Structure Type | LTOWER - Lattice Tower | |
Tower Owner | KVOA-TV | |
Date Constructed | 01/01/1998 |
Section | Question | Response |
---|---|---|
Engineering Study | Please what type of engineering study is required, if any: | Tower mapping and report for structural engineer |
Tower Reinforcements | Please select whether tower reinforcements are needed: | No 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 | 150 | |
Explanation | Required to assist in the turnkey management of the channel relocation project in order that the existing internal personal can maintain and operate the stations daily operational requirements and plans. | |
Outside RF consulting Engineering Services | Perform engineering study for displacement application | 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 | |
Prepare Form 601 | Yes | |
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 | |
Negotiation of Lease and other Matter for Shared Locations | Yes | |
Prepare or Review FCC Form 399 for Reimbursement | Yes | |
Form 399 assistance or other program management costs | Yes | |
RF Field Engineering Services | Comprehensive coverage verification via field study | Yes |
RF exposure measurements | No | |
Additional Field Engineering Service | No |
Name | Description |
---|---|
Attorney Fees for displacement |
Displacement Legal Services. |
General Legal |
General Legal expenses associated with Repack |
General Engineering Services |
General engineering services related to Repack |
Section | Question | Response |
---|---|---|
AM Pattern Disturbance | Is an Impact Study needed? | No |
Is Remediation needed? | No | |
Permit and Filing Costs | FCC Construction Permit Major Change | Yes |
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 | |
Point to Point Microwave (STL/ICR) | Frequency Coordination for Unidirection System | No |
Frequency Coordination for Bi-Direction System | No | |
New Point to Point Microwave System | Yes | |
Type | 7/13 GHz Licensed Part 74 |
Name | Description |
---|---|
MW Shipping fees |
Shipping fees for new MW system |
MW installation |
Installation of new MW system |
MW sales tax |
Sales tax on MW system |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $129,786.09 | $139,786.09 | N/A | $75,025.63 | N/A |
Total for all systems | $413,545.17 | $451,281.77 | N/A | $117,375.45 | N/A |
Primary Transmitter UAXTE-2R37 | $129,786.09 | $139,786.09 | $75,025.63 | ||
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW | $84,000.00 | $84,000.00 | N/A | $63,671.95 | N/A |
Transmitter Building Site Survey/Installation | $10,000.00 | $20,000.00 | Estimated costs for site survey and transmitter installation. Revised upon Site Survey. | N/A | N/A |
Power Supply | $669.42 | $669.42 | Power adapter - Quote WISQ54012 | $669.42 | N/A |
Decommissioning | $4,000.00 | $4,000.00 | Estimated costs of harvesting and removal of old transmitter from site. Revised upon Site Survey. | $0.00 | N/A |
Spares, adapters, cable assemblies, etc. | $12,000.00 | $12,000.00 | Estimate of misc parts, spares, cables, assemblies, etc to connect new equipment to existing system. Actual costs to be determined. | $0.00 | N/A |
Site Prep | $6,000.00 | $6,000.00 | Site preparation including receiving and inventory of transmitter and components; prepare site for acceptance of transmitter; pre-assemble cabinets and subassemblies; ensure all installation materials are available for installation crew. | N/A | N/A |
Switch | $706.01 | $706.01 | Actual costs for Cisco switch - Heartland 66239 - PO K28OY | $706.01 | N/A |
Decoder | $3,609.72 | $3,609.72 | Sencore SD 4:2:0 SDI/Discrete Video Decode Module actual costs | $3,609.72 | N/A |
Transmitter Shipping fee | $2,500.00 | $2,500.00 | Estimated shipping fees for new transmitter. Actual costs to be determined. | $67.59 | N/A |
Transmitter Taxes | $6,300.94 | $6,300.94 | Per attached GatesAir invoice. | $6,300.94 | N/A |
Actual Information Description | File Name |
---|---|
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW | |
Transmitter Building Site Survey/Installation | Information not provided. |
Power Supply | |
Decommissioning | Information not provided. |
Spares, adapters, cable assemblies, etc. | |
Site Prep | Information not provided. |
Switch | |
Decoder | |
Transmitter Shipping fee | |
Transmitter Taxes |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $29,232.20 | $29,232.20 | N/A | $15,988.60 | N/A |
Total for all systems | $413,545.17 | $451,281.77 | N/A | $117,375.45 | N/A |
Primary Antenna ATC-BCE414C2-V4-28 | $29,232.20 | $29,232.20 | $15,988.60 | ||
Side Mount antenna brackets | $4,625.00 | $4,625.00 | N/A | N/A | N/A |
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Elliptical | $15,988.60 | $15,988.60 | ***System Notice: Estimate adjusted and locked because line has been superseded.***Estimated amount does not include E-POL upgrade, but does include taxes and shipping per the (2) Alive Telecom Invoices/Quotes | $15,988.60 | Per actual invoices from Alive Telecom. |
Sweep test of transmission line and antenna | $5,730.00 | $5,730.00 | N/A | N/A | N/A |
Antenna Shipping fee | $1,665.00 | $1,665.00 | Per attached Alive invoice. | N/A | N/A |
Antenna Sales Tax | $1,223.60 | $1,223.60 | Per attached Alive invoice. | N/A | N/A |
Actual Information Description | File Name |
---|---|
Side Mount antenna brackets | Information not provided. |
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Elliptical | |
Sweep test of transmission line and antenna | Information not provided. |
Antenna Shipping fee | Information not provided. |
Antenna Sales Tax | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $1,198.68 | $1,198.68 | N/A | $0.00 | N/A |
Total for all systems | $413,545.17 | $451,281.77 | N/A | $117,375.45 | N/A |
Primary Transmission Line | $1,198.68 | $1,198.68 | $0.00 | ||
Flexible Foam Transmission Line - dielectric, 7/8" | $1,100.00 | $1,100.00 | N/A | $0.00 | N/A |
Transmission line shipping | $35.50 | $35.50 | Per attached Heartland invoice. | N/A | N/A |
Transmission line taxes | $63.18 | $63.18 | Per attached Heartland invoice. | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $77,190.00 | $77,190.00 | N/A | $5,085.00 | N/A |
Total for all systems | $413,545.17 | $451,281.77 | N/A | $117,375.45 | N/A |
Primary Tower LTOWER | $77,190.00 | $77,190.00 | $5,085.00 | ||
Tower Rigging Short Tower (less than 500') | $56,190.00 | $56,190.00 | N/A | $5,085.00 | N/A |
Tower mapping and report for structural engineer | $21,000.00 | $21,000.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
Tower Rigging Short Tower (less than 500') | |
Tower mapping and report for structural engineer | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $103,259.00 | $102,456.00 | N/A | $21,276.22 | N/A |
Total for all systems | $413,545.17 | $451,281.77 | N/A | $117,375.45 | N/A |
Outside Professional Services | $103,259.00 | $102,456.00 | $21,276.22 | ||
Prepare request for Special Temporary Authorization | $1,280.00 | $1,280.00 | N/A | N/A | N/A |
Prepare Form 601 | $755.00 | $755.00 | N/A | N/A | N/A |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $1,577.50 | $1,577.50 | N/A | $0.00 | N/A |
Attorney Fees for displacement | $364.00 | $364.00 | Displacement legal fees actual costs | $364.00 | N/A |
Project management of the transition | $15,825.00 | $23,100.00 | Estimated 150 hours at $154/hr. Actual costs to be determined. | $5,852.10 | N/A |
Prepare/ Review 399 reimbursement form | $1,710.00 | $2,500.00 | Per attached QCommunications quote. | $2,500.00 | N/A |
Form 399 assistance or other Program Management costs | $5,890.00 | $5,890.00 | Per attached QCommunications quote. | $3,353.62 | N/A |
Perform engineering study for displacement application | $1,800.00 | $1,800.00 | N/A | $450.00 | N/A |
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | $2,102.50 | $2,102.50 | N/A | $1,040.00 | N/A |
Prepare engineering section of FCC Form 2100 (main), License to Cover Application | $1,052.50 | $1,052.50 | N/A | $510.00 | N/A |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $3,025.00 | $3,025.00 | N/A | $0.00 | N/A |
Attorney Fees - Negotiation of lease and other matters for shared locations | $3,262.50 | $3,262.50 | N/A | N/A | N/A |
Attorney Fees - Prepare and File request for Special Temporary Authorization | $2,235.00 | $2,235.00 | N/A | N/A | N/A |
Comprehensive coverage verification via field study, if needed | $52,600.00 | $43,732.00 | QForce quote 720-R | N/A | N/A |
General Legal | $5,000.00 | $5,000.00 | Estimated costs for general legal expenses associated with Repack | $2,426.50 | N/A |
General Engineering Services | $4,780.00 | $4,780.00 | General consulting engineering related to Repack activities | $4,780.00 | N/A |
Actual Information Description | File Name |
---|---|
Prepare request for Special Temporary Authorization | Information not provided. |
Prepare Form 601 | Information not provided. |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | Information not provided. |
Attorney Fees for displacement | |
Project management of the transition | |
Prepare/ Review 399 reimbursement form | |
Form 399 assistance or other Program Management costs | |
Perform engineering study for displacement application | |
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | |
Prepare engineering section of FCC Form 2100 (main), License to Cover Application | |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | Information not provided. |
Attorney Fees - Negotiation of lease and other matters for shared locations | Information not provided. |
Attorney Fees - Prepare and File request for Special Temporary Authorization | Information not provided. |
Comprehensive coverage verification via field study, if needed | Information not provided. |
General Legal | |
General Engineering Services |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $72,879.20 | $101,418.80 | N/A | $0.00 | N/A |
Total for all systems | $413,545.17 | $451,281.77 | N/A | $117,375.45 | N/A |
Other Expenses | $72,879.20 | $101,418.80 | $0.00 | ||
MW sales tax | $6,341.90 | $6,341.90 | Per attached Heartland invoice 67221. | $0.00 | N/A |
FCC Filing Fees - Form 2100 minor change CP application | $1,110.00 | $1,110.00 | N/A | N/A | N/A |
FCC Filing Fees - Form 2100 license to cover application | $335.00 | $335.00 | N/A | N/A | N/A |
FCC Filing Fees - Form 2100 Major change CP application | $4,960.00 | $4,960.00 | N/A | N/A | N/A |
FCC Filing Fees - Special Temporary Authorization request | $305.00 | $305.00 | N/A | N/A | N/A |
Disposal Costs (for equipment and other waste, net of any salvage value) | $2,000.00 | $2,000.00 | Estimated 4-6 yard disposal bin on site to capture all waste from on site system integration and tower vendors. Actual costs to be determined. | N/A | N/A |
Equipment Delivery and Handling Charges | $2,000.00 | $2,000.00 | Estimated transport, forklift rental and handling fees from staging area to transmitter site. Actuals to be determined. | N/A | N/A |
Equipment Storage | $2,000.00 | $2,000.00 | Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. | N/A | N/A |
New Point to Point Microwave System: 7/13 GHz Licensed Part 74 | $51,300.00 | $79,839.60 | Per attached Heartland Quote CRDQ1366-03. Estimated cost has been adjusted to actual costs including taxes and shipping not included on original quote. | $0.00 | N/A |
MW Shipping fees | $602.30 | $602.30 | Per attached Heartland invoice 67221. | $0.00 | N/A |
MW installation | $1,925.00 | $1,925.00 | Per attached Heartland invoice 67221. | $0.00 | Cost to install MW is $6450 per attached invoices DP36518 and 67221 |
Actual Information Description | File Name |
---|---|
MW sales tax | |
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 - Form 2100 Major change CP 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 | Information not provided. |
Equipment Storage | Information not provided. |
New Point to Point Microwave System: 7/13 GHz Licensed Part 74 | |
MW Shipping fees | |
MW installation |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $413,545.17 | $451,281.77 | $117,375.45 |
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 |
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. | Jeffrey W Mayes Applicant 07/01/2022 |
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. | Jeffrey W Mayes Applicant 07/01/2022 |