Application for an International Broadcast Station License

Federal Communications Commission Approved by OMB

Washington, D.C. 20554 3060-1056

FCC 420-IB

APPLICATION FOR AUTHORITY TO CONSTRUCT OR

MAKE CHANGES IN AN INTERNATIONAL BROADCAST STATION

INSTRUCTIONS

A. This form is to be used in applying for authority to construct a new International Broadcast station, or to make changes in an existing International Facility. This form consists of this part, Section 1, and the following sections:

Section II - Legal Qualifications

Section III - Financial Qualifications

Section IV – Statement of Program Service of Broadcast Applicant

Section V - Equal Employment Opportunity Program

Section VI – Engineering Data

B. Prepare an original and two copies of this form and all exhibits. File with the Federal Communications Commission, Washington, D.C. 20554.

C. Number exhibits serially in the space provided in the form and date each exhibit.

D. The name of the applicant should herein shall be the exact corporate name, if a corporation; if a partnership, the names of all partners and the name under which the partnership does business; if an unincorporated association, the name of an executive officer, his office, and the name of the association.

E. Information called for by this application which is already on file with the Commission need not be refilled in this application provided (1) the information is now on file in another application or FCC Form filed by or on behalf of this applicant; (2) the information is identified fully by reference to the file number (if any), the FCC Form number, and the filing date of the application or other form containing the information and the page or paragraph referred to; and (3) after making the reference, the applicant states: “No change since date of filing.” Any such reference will be considered to incorporate into this application all information, confidential or otherwise, contained in the application or other form referred to. The incorporated application or other form will thereafter, in its entirety, be open to the public.

F. If the applicant is now licensee of an International broadcast station, Section II need not be completed.

G. The applicant, or the applicant's authorized representative, must sign the application. Depending on the nature of the applicant, the application should be signed as follows: if a sole proprietorship, personally; if a partnership, by a general partner; if a corporation, by an officer; for an unincorporated association, by a member who is an officer; if a governmental entity, by such duly elected or appointed official as is competent under the laws of the particular jurisdiction. Counsel may sign the application for his or her client, but only in cases of the applicant's disability or absence from the United States. In such cases, counsel must separately set forth why the application is not signed by the client. In addition, as to any matter stated on the basis of belief instead of personal knowledge, counsel shall separately set forth the reasons for believing that such statements are true. See 47 C.F.R. Section 73.3513.

H. Before filling out this applicant, the applicant should familiarize himself/herself with the Communications Act of 1934, as amended, Parts 1, 2, 17, 73 and 74 of the Commission’s Rules and Regulations, and the International and Telecommunications Union’s Radio Regulations, as appropriate.

G. Be sure all necessary information is furnished and all paragraphs are fully answered. If any portions of the application are not applicable, specifically so state. Defective or incomplete applications may be returned without consideration.

FCC NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT AND THE PAPERWORK REDUCTION ACT

The FCC is authorized under the Communications Act of 1934, as amended, to collect the personal information we request in this form. We will use the information provided in the application to determine whether approving this application is in the public interest. If we believe there may be a violation or potential violation of a FCC statute, regulation, rule or order, your application may be referred to the Federal, state or local agency responsible for investigating, prosecuting, enforcing or implementing the statute, rule, regulation or order. In certain cases, the information in your application may be disclosed to the Department of Justice or a court or adjudicative body when (a) the FCC; (b) any employee of the FCC; or (c) the United States Government is a party to a proceeding before the body or has an interest in the proceeding. In addition, all information provided in this form will be available for public inspection.

If you owe a past due debt to the federal government, any information you provide may also be disclosed to the Department of Treasury Financial Management Service, other federal agencies and/or your employer to offset your salary, IRS tax refund or other payments to collect that debt. The FCC may also provide this information to these agencies through the matching of computer records when authorized.

If you do not provide the information requested on this form, the application may be returned without action having been taken upon it or its processing may be delayed while a request is made to provide the missing information. Your response is required to obtain the requested authorization.

We have estimated that each response to this collection of information will take _____hours depending on the type of application filed. Our estimate includes the time to read the instructions, look through existing records, gather and maintain the required data, and actually complete and review the form or response. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you, please write the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-XXXX), Washington, DC 20554. We will also accept your comments via the Internet if your send them to [email protected]. Please DO NOT SEND COMPLETED APPLICATIONS TO THIS ADDRESS. Remember - you are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number of if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-XXXX.

THE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OF 1974, P.L. 93-579, DECEMBER 31, 1974, 5 U.S.C. 552a(e)(3), AND THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13, OCTOBER 1, 1995, 44 U.S.C. 3507.

FCC 420-IB

INSERT DATE