TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
IHM LICENSES, LLC Doing Business As: IHM LICENSES, LLC	7136 S. YALE AVENUE TULSA, OK 74136 United States	+1 (918) 664-4581	FCCCONTACT@IHEARTMEDIA.COM

Applicant

Address

Phone

Applicant Type

IHM LICENSES, LLC

Doing Business As: IHM LICENSES, LLC

7136 S. YALE AVENUE

TULSA, OK 74136

United States

+1 (918) 664-4581

FCCCONTACT@IHEARTMEDIA.COM

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
The Preparer is same as the reimbursement contact.

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.	No
Briefly describe transition plan	Forced off main antenna, moved to New Repack Aux as the rigging needed to remain on the tower and within our antenna apertures for the duration of the project to meet the accelerated TV schedule.

Transmitters

Section	Question	Response
Transmitter Related Expenses	Do you have transmitter related expenses?	No

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	Purchase New
	Antenna Use	Primary (Main)
	Ownership	Owned
	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
	Mounting	Side Mount
	Antenna position in stack	Middle
	Polarization	Circular
	Type	Cross Dipole
	ERP:	15.0 kW
	Manufacturer
	Model	SHPX-2AE
	Year	2001

Primary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Primary (Main)
	Change Type	Purchase New
	Ownership	Owned
	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
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Circular
	Type	Cross Dipole
	ERP:	5.3 kW
	Manufacturer
	Model	SHPX-4AE-HW
	Year	2019
	Justification for New Antenna	Locate on pole near existing site, not having to remove existing antenna, move it to pole, then move it back, while not having access to any aux during those moves.

Primary Antenna

Other Antenna Costs

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?	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?	No
FM Band Pass Filters	Do you require an FM band pass filter?	No
Notch Filter	Do you require a Notch filter?	No
De-Icers	Do you require De-Icers?	No
Radomes	Do you require Radomes?	No

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Equipment Delivery and Handling Charges	Equipment Delivery and Handling Charges

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	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 Air
	Diameter	3 inches
	Number of parallel runs	1
	Length	180 feet per run

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Type	Flexible Air
	Diameter	3 inches
	Number of parallel runs	1
	Length	50 feet per run
	Justification for New Transmission Line	To not have to dismount, mount at temp, dismount at temp and remount at existing site.
Interior RF Systems	Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators?	Yes
Interior RF Systems	Does the Installation of the Transmission Line require additional or replacement Inside RF system elbows, fitting, hangers, etc.?	Yes

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

Section	Question	Response
Tower Equipment or Rigging Costs Changes	Do you have tower equipment or rigging costs changes?	Yes

Primary Tower

Existing Tower

Section	Question	Response
Existing Tower Description	Type of change	Modify Existing
	Tower Use	Primary (Main)
	Ownership	Leased
	Is this tower consider Complex?	No
	Is this tower currently shared with any other stations?	No
	Is tower documented for structural analysis?	Unknown
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	No
Coordinates (NAD83)	Latitude (NAD83)	40° 20' 42.3" N-
	Longitude (NAD83)	076° 52' 10.1" W-
	Overall Structure Height	49.00 feet
	Support Structure Height	49.00 feet
	Ground Elevation Above Mean Sea Level (AMSL)	1309.00 feet
	Structure Type	POLE - Any type of Pole
	Tower Owner	Vertical Bridge
	Date Constructed	01/01/1900

Primary Tower

Tower Modification Costs

Section	Question	Response
Engineering Study	Please what type of engineering study is required, if any:	No study needed
Tower Reinforcements	Please select whether tower reinforcements are needed:	No reinforcements needed

Primary Tower

Tower Rigging Costs

Section	Question	Response
Tower Rigging Costs	Complex Tower	N/A
Helicopter Services Required	Are helicopter services required?	No

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Ant and Line Install on Tower	Install exterior equipment/line/ant

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	No
Outside RF consulting Engineering Services	Prepare engineering section of Form FCC Construction Permit Application	No
	Prepare engineering section of Form FCC License to Cover Application	No
	Prepare request for Special Temporary Authority	No
	Prepare Form 601	No
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	No
	Prepare and file Form FCC License to Cover Application	No
	Prepare request for Special Temporary Authority	No
	Negotiation of Lease and other Matter for Shared Locations	No
	Prepare or Review FCC Form 399 for Reimbursement	No
	Form 399 assistance or other program management costs	No
RF Field Engineering Services	Comprehensive coverage verification via field study	No
	RF exposure measurements	No
	Additional Field Engineering Service	No

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
Prepare and or review reimbursement form	Prepare and or review reimbursement form

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	Is Remediation needed?	No
Permit and Filing Costs	FCC Construction Permit Major Change	No
	FCC Construction Permit Minor Change	Yes
	FCC License to Cover Application	Yes
	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)?	No
	Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs?	No
	Does this relocation require Equipment Storage?	No
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	No
	1 pair IP-only Codecs for fiber, internet or IP microwave systems	No

Other Expenses

Other Expenses Not Listed

Information not provided.

Cost Information

Transmitters

Information not provided.

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	$25,453.50	$25,453.50	N/A	$25,453.50	N/A
Total for all systems	$133,604.41	$61,544.22	N/A	$61,009.22	N/A
Primary Antenna SHPX-4AE-HW	$25,453.50	$25,453.50		$25,453.50
Side Mount, Cross Dipole, 5.3kW input, Circular	$24,549.50	$24,549.50	See attached invoice and quote	$24,549.50	50 cent difference
Equipment Delivery and Handling Charges	$904.00	$904.00	See attached invoice	$904.00	N/A

Components

Actual Information Description	File Name
Side Mount, Cross Dipole, 5.3kW input, Circular	Component Description: Antenna Amount: N/A Component Description: ERI 53342 v201125pmv3 Amount: $24,549.50
Equipment Delivery and Handling Charges	Component Description: ERI 53342 v201125pmv3 Amount: $904.00

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	$18,497.91	$20,087.72	N/A	$20,087.72	N/A
Total for all systems	$133,604.41	$61,544.22	N/A	$61,009.22	N/A
Primary Transmission Line	$18,497.91	$20,087.72		$20,087.72
Interior RF Systems: Elbows, fitting, hangers, etc.	$3,547.55	$3,547.55	Hardline used inside.	$3,547.55	Shipping and Tax differences
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators	$12,000.36	$12,000.36	Motorized RF switch and associated controller, as well as wattmeter.	$12,000.36	N/A
Flexible Air Transmission Line - dielectric, 3"	$2,950.00	$4,539.81	Price includes all Hangers, flanges, etc; not just cost of bare line.	$4,539.81	N/A

Components

Actual Information Description	File Name
Interior RF Systems: Elbows, fitting, hangers, etc.	Component Description: SCMS 129648 v201029pmv2 Amount: $1,788.11 Component Description: part of int system Amount: $1,583.11 Component Description: Flanges Amount: $176.33
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators	Component Description: SCMS 129648 v201029pmv2 Amount: $12,000.36
Flexible Air Transmission Line - dielectric, 3"	Component Description: SCMS 129648 v201029pmv2 Amount: $4,539.81

Cost Information

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	$86,010.00	$12,360.00	N/A	$12,360.00	N/A
Total for all systems	$133,604.41	$61,544.22	N/A	$61,009.22	N/A
Primary Tower POLE	$86,010.00	$12,360.00		$12,360.00
Tower Rigging Short Tower (less than 500')	$73,650.00	$0.00	N/A	N/A	N/A
Ant and Line Install on Tower	$12,360.00	$12,360.00	N/A	$12,360.00	N/A

Components

Actual Information Description	File Name
Tower Rigging Short Tower (less than 500')	Information not provided.
Ant and Line Install on Tower	Component Description: Tower work Invoice with Call sign Amount: $12,360.00 Component Description: Tower work for new aux ant and line Amount: N/A

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	$3,108.00	$3,108.00	N/A	$3,108.00	N/A
Total for all systems	$133,604.41	$61,544.22	N/A	$61,009.22	N/A
Outside Professional Services	$3,108.00	$3,108.00		$3,108.00
Prepare and or review reimbursement form	$3,108.00	$3,108.00	See attached invoices.	$3,108.00	N/A

Components

Actual Information Description	File Name
Prepare and or review reimbursement form	Component Description: KGA 991-31 v201013pmv1 Amount: $605.00 Component Description: KGA 991-72 v220302pmv1 Amount: $620.00 Component Description: KGA 991-221 v220310pmv1 Amount: $128.00 Component Description: KGA 991-79 v220302pmv1 Amount: $75.00 Component Description: KGA 991-47 v201202pmv1 Amount: $870.00 Component Description: KGA 991-233 v220519pmv1 Amount: $160.00 Component Description: KGA 991-84 v220302pmv1 Amount: $50.00 Component Description: KGA 991-62 v201210pmv1 Amount: $500.00 Component Description: KGA 991-15 v201013pmv1 Amount: $100.00

Actual Information Description

File Name

Prepare and or review reimbursement form

Component Description:: KGA 991-31 v201013pmv1
Amount:: $605.00

Component Description:: KGA 991-72 v220302pmv1
Amount:: $620.00

Component Description:: KGA 991-221 v220310pmv1
Amount:: $128.00

Component Description:: KGA 991-79 v220302pmv1
Amount:: $75.00

Component Description:: KGA 991-47 v201202pmv1
Amount:: $870.00

Component Description:: KGA 991-233 v220519pmv1
Amount:: $160.00

Component Description:: KGA 991-84 v220302pmv1
Amount:: $50.00

Component Description:: KGA 991-62 v201210pmv1
Amount:: $500.00

Component Description:: KGA 991-15 v201013pmv1
Amount:: $100.00

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	$535.00	$535.00	N/A	$0.00	N/A
Total for all systems	$133,604.41	$61,544.22	N/A	$61,009.22	N/A
Other Expenses	$535.00	$535.00		$0.00
FCC Filing Fees - Form 2100 minor change CP application	$200.00	$200.00	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

Components

Information not provided.

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$133,604.41	$61,544.22	$61,009.22

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 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.
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. 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 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). 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 certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred. 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.	Jeffrey C Gehman Engineering Associate 08/31/2022

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.

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.
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 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).
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 certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.
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.

Jeffrey C Gehman

Engineering Associate

08/31/2022

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.	Jeffrey C Gehman Engineering Associate 08/31/2022

Section

Question

Response

Submission of Final Allocation or Accounting Information Statements

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.

Jeffrey C Gehman

Engineering Associate

08/31/2022

(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

Antennas

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

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

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components

Cost Information

Grand Total

Reimbursement Status

Certification

Certification

Attachments