Form FCC Form 423-IB FCC Form 423-IB Application for Permit to Deliver Programs to Foreign Br

FOR COMMISSION USE ONLY Approved by OMB File No. _____________________ 3060-1055 United States of America Federal Communications Commission Washington, DC 20554 APPLICATION FOR PERMIT TO DELIVER PROGRAMS TO FOREIGN BROADCAST STATIONS (Carefully read instructions before filling out Form – RETURN ONLY FORM TO FCC)
1. Name of applicant	Street Address or P.O. Box	City		State			Zip Code	Telephone No. (include area code)
2. Name and address to whom communication should be sent if different from Item 1.
Name	Street Address or P.O. Box	City	State		Zip Code			Telephone No. (include area code)
3. Legal identity of applicant: (only check one box)
Individual	Partnership	Corporation				Government Entity			Other
If Other Specify:
4. Application is for:
New Authorization			Extension of Existing Authority
5. If applicant is an individual, is applicant a citizen of the United States?									YES NO
6. If applicant is a partnership, are all partners citizens of the United States?									YES NO
7. If applicant is a corporation:
a. Under laws of what state was it organized?
b. Is more than one-fifth of the capital stock of the corporation owned of record or may it be voted by aliens or their representatives or by a foreign government or representative thereof, or by any corporation organized under the laws of a foreign country?									YES NO
c. Is any officer or director of the corporation an alien?									YES NO
If the answer is Yes, give the following for each:
Name		Nationality				Position
									FCC 423-IB (Page 1) April 2004

d. Is applicant directly or indirectly controlled by any other corporation?					YES		NO
If the answer is Yes, give the following for the controlling corporation.
Name	Address		State in which organized
e. Is more than one-fourth of the capital stock of the controlling corporation either owned of record, or may it be voted by aliens, their representatives, or by a foreign government or representative thereof, or by any corporation organized under the laws of a foreign country?					YES		NO
f. Is any officer or more than one-fourth of the directors of the corporation an alien?					YES		NO
If the answer is Yes, give the name, nationality, and position of each, and give the Total number of directors of the corporation.
Name	Nationality	Position	Number of Directors
g. Is the above-described controlling corporation in turn a subsidiary?					YES	NO
If the answer is Yes, attach as Exhibit No. ______ additional information answering the holding company questions in this paragraph for each company, to and including the organization having ultimate control.
8a. If the applicant is an unincorporated association, give the following:
Total number of members		Number of Alien members (if any)
b. State the following for alien officers or directors (if any):
Name		Nationality		Position
FCC 423-IB (Page 2) April 2004

9.a. What is applicant’s principal business?
b. Does applicant or any party to this application have any interest in, or connection with, any AM, FM, or TV broadcast station (either domestic or foreign), or any application pending before the Commission?						YES		NO
If the answer is Yes, attach Exhibit No. ______ giving complete details.
10. Is applicant a representative of an alien or of a foreign government?						YES		NO
If the answer is Yes, explain.
11. a. Has any radio station authorization previously issued to the applicant or party to this application been revoked, either by the Commission or by any court?					YES		NO
b. Has any previous application by the applicant or party to this application been denied by the Commission or by a predecessor agency?					YES		NO
If the answer to (a) and/or (b) is Yes, explain:
12. a. Has applicant or any party to this application been found guilty by any court of any felony?					YES		NO
b. Has applicant or any party to this application been finally adjudged guilty by a Federal court of the violation of the laws of the United States relating to unlawful monopoly, restraint of trade, and/or unfair methods of competition?					YES		NO
If the answer to (a) and/or (b) is Yes, explain.
							FCC 423-IB (Page 3) April 2004

13. Address of studio or other place at which programs will originate:
14. State ownership of originating facilities.
15. Describe the means (wireline, radio link, or other method) whereby programs will be delivered, to foreign station(s), including names of any interconnecting common carriers.
16. Give the location, type, and authorized power of foreign station(s) to which programs will de delivered, and identify the licensee or operating agency of such station(s).
17. Attach as Exhibit No. _______ a full explanation of the legal relationship between the applicant and foreign station(s) involved, including a copy of contract (if any) which foreign station(s).
18. (a) Attach as Exhibit No. ________ a statement as to whether program deliveries are to be intermittent or regularly scheduled, and the average number of hours per day, week and/or month during which the foreign station(s) involved will broadcast such programs.
(b) Attach as Exhibit No. ________ a detailed description of the nature and character of the programming proposed and the language to be employed.
CERTIFICATION
The APPLICANT acknowledges that all statements contained in this application and attached exhibits are material representations, and that the exhibits forming a part of this application are incorporated herein as if set out in full in the application. The undersigned certifies that the statements contained in this application are true, complete, and correct to the best of his/her knowledge and belief and are made in good faith.
Signed and dated this			_____________		day of	__________________________		, 20_______.
						By
(Name of Applicant)							(Signature)
		WILLFUL FALSE STATEMENTS
		MADE ON THIS FORM					(Title)
		ARE PUNISHABLE BY
		FINE AND IMPRISONMENT
		U.S. CODE, TITLE 18,
		SECTION 1001.
EXHIBITS furnished as required by this form:
Exhibit No.				Para. No. of Form	Name of officer or employee (1) by whom or (2) under whose direction exhibit was prepared (show which)			Official Title
Form 423-IB (Page 4) April 2004