Analog Termination Form

APPENDIX B

FORMS

Form 1

Drop down: ANALOG SERVICE TERMINATION NOTIFICATION¹

1. Select the appropriate button below:

(Choice 1a Instruction: Select this choice if you will continue analog service until the June 12 transition deadline.)

◦ This is BINDING notification that the above-referenced station will terminate analog television broadcast signals (excluding statutory analog nightlight service, if applicable) on the June 12, 2009 transition deadline at the following local time of day:

◦ Early Morning (12:00 AM – 6:00 AM)

◦ Morning (6:01 AM – 12:00 PM Noon)

◦ Afternoon (12:01 PM – 6:00 PM)

◦ Evening (6:01 PM – 11:59 PM).

(If this button is selected, go to question 2.)

(Choice 1b Instruction: Select this choice if you want to terminate analog service before April 16 and are a noncommercial educational station that will certify to significant financial hardship.)

◦ This is BINDING notification that the above-referenced station, which is a Noncommercial Educational station, will terminate analog television broadcast signals (excluding informal analog nightlight service, if applicable) on the following date before April 16 because of significant financial hardship: MM/DD/2009 at the following local time of day:

◦ Early Morning (12:00 AM – 6:00 AM)

◦ Morning (6:01 AM – 12:00 PM Noon)

◦ Afternoon (12:01 PM – 6:00 PM)

◦ Evening (6:01 PM – 11:59 PM).

(Note: The date selected may not be earlier than March 27 or later than April 15, 2009. Stations electing to transition on the June 12, 2009 transition deadline should select the first option, above. Stations electing to transition before the June 12, 2009 transition deadline, but after April 16, 2009, should select the third option, below. We remind stations that they must obtain Commission approval to operate a post-transition digital facility prior to June 13, 2009.) (If this button is selected, go to question 3.)

(Choice 1c Instruction: Select this choice if you want to terminate analog service early and are not a major network affiliate station.)

◦ This is BINDING notification that the above-referenced station, which is NOT a major network affiliate (i.e., an affiliate of ABC, CBS, FOX, or NBC), will terminate analog television broadcast signals (excluding informal analog nightlight service, if applicable) on the following date: MM/DD/2009 after April 15 at the following local time of day:

◦ Early Morning (12:00 AM – 6:00 AM)

◦ Morning (6:01 AM – 12:00 PM Noon)

◦ Afternoon (12:01 PM – 6:00 PM)

◦ Evening (6:01 PM – 11:59 PM).

(Note: The date selected may not be earlier than April 16 or later than June 11, 2009. Stations electing to transition on the June 12, 2009 transition deadline should select the first option, above. We remind stations that they must obtain Commission approval to operate a post-transition digital facility prior to June 13, 2009.) (If this button is selected, go to question 4.)

(Choice 1d Instruction: Select this choice if you want to terminate analog service early and are a major network affiliate station.)

◦ This is BINDING notification that the above-referenced station, which IS a major network affiliate (i.e., an affiliate of ABC, CBS, FOX, or NBC), will terminate analog television broadcast signals (excluding enhanced analog nightlight service, if applicable) on the following date: MM/DD/2009 after April 15 at the following local time of day:

◦ Early Morning (12:00 AM – 6:00 AM)

◦ Morning (6:01 AM – 12:00 PM Noon)

◦ Afternoon (12:01 PM – 6:00 PM)

◦ Evening (6:01 PM – 11:59 PM).

(Note: The date indicated may not be earlier than April 16 or later than June 11, 2009. Stations electing to transition on the June 12, 2009 transition deadline should select the first option, above. We remind stations that they must obtain Commission approval to operate a post-transition digital facility prior to June 13, 2009.) (If this button is selected, go to question 5.)

[NOTE to question 2: The following question applies only to stations that will terminate analog television service on the June 12, 2009 transition deadline.]

2.a. Statutory analog nightlight service. If the above-referenced station is determined by the FCC to be eligible to participate in the statutory analog nightlight program (i.e., for up to 30 days after the June 12, 2009 transition deadline), does the station intend to provide statutory analog nightlight service?

(Note: Statutory analog nightlight service must be provided for no more than 30 days, but no less than two weeks, after the June 12, 2009 transition deadline.)

YES ___ NO ___

2.b. If YES, the station will provide statutory analog nightlight service from June 13, 2009 until the following date, which must fall between June 26 and July 12, 2009, inclusive: MM/DD/2009.

Go to question 7.

[NOTE to question 3: The following certification applies only to Noncommercial Educational (NCE) stations that will terminate analog television service before April 16.]

3. NCE Early Termination Certification.

◦ Licensee CERTIFIES that the above-referenced NCE station must terminate analog television service before April 16 due to significant financial hardship.

YES ___ NO­ ___

Go to question 4.

[NOTE to question 4: The following question applies only to stations that will terminate analog television service early, i.e., before the June 12, 2009 transition deadline, and are not subject to mandatory enhanced nightlight obligations.]

4.a. Voluntary analog nightlight service. After this station’s analog termination date, as indicated above, does this station intend to provide voluntary analog nightlight service, i.e., the station will continue broadcasting in analog to provide DTV transition information and, if necessary, emergency information?

YES ___ NO­ ___

4.b. If YES, the station will provide such informal analog nightlight service until the following date, which must be no later than the June 12, 2009 transition deadline: MM/DD/2009.

Go to question 7.

[NOTE to question 5: The following question applies only to stations that ARE major network affiliates and that will terminate analog television service early, i.e., prior to the June 12, 2009 transition deadline.]

5. Major Network Affiliate Early Termination Certification. Each major network affiliate station that will terminate analog television broadcast signals prior to the June 12, 2009 transition deadline must, as a condition of such early analog termination, CERTIFY to one of the following statements:

(Choice 5a Instruction: Select this choice if you yourself will fully comply with all public interest related conditions.)

◦ Licensee CERTIFIES that the above-referenced station will itself fully comply with each of the public interest related conditions² for early analog termination set forth in the Commission Report and Order, FCC 09-19, adopted March 13, 2009. (If this button is selected, go to question 7.)

(Choice 5b Instruction: Select this choice if you will rely on another station or stations to satisfy one or more of the public interest related conditions. NOTE: If you are relying on another major network affiliate to provide continuing full analog service to at least 90 percent of the population in your Grade B analog contour through June 12, 2009, select Choice 5c.)

◦ Licensee CERTIFIES that the above-referenced station will rely in whole or in part on one or more major network affiliated station(s) to fully comply with the public interest related conditions³ for early analog termination set forth in the Commission Report and Order, FCC 09-19, adopted March 13, 2009(listed in question 6).

(If this button is selected, go to question 6.)

(Choice 5c Instruction: Select this choice if you will rely on one or more other major network affiliated station(s) to provide continuing full analog service to 90% of the viewers in your Grade B analog contour through June 12, 2009. NOTE: If you are relying on enhanced nightlight coverage, select Choice 5b.)

◦ Licensee CERTIFIES that the above-referenced station will rely on the following major network affiliated station(s) to provide continuing full analog television service to its analog viewers until June 12, 2009, and that the station(s) listed individually or collectively cover, at a minimum, 90% of the population in the Grade B analog contour of the above-referenced station; and, therefore, the station does NOT need to comply with the public interest related conditions for early analog termination set forth in the Commission Report and Order, FCC 09-19, adopted March 13, 2009: ____________ (List licensee name(s), call sign(s) and location(s).)

(If this button is selected, go to question 4.)

(Choice 5d Instruction: Select this choice if you will demonstrate “extraordinary, exigent circumstances” in an exhibit)

◦ Licensee CERTIFIES that the above-referenced station will experience extraordinary, exigent circumstances and, therefore, CANNOT fully comply with the public interest related conditions for early analog termination set forth in the Commission Report and Order, FCC 09-19, adopted March 13, 2009. Instead, it makes the alternative showing of extraordinary, exigent circumstances in the attached required EXHIBIT and seeks Commission approval for early analog termination on this basis.

[Ex No. ]

(Note: The showing in the attached exhibit must not exceed five (5) pages, not including attachments. Stations selecting this option must obtain express Commission approval before they may terminate analog service early.)

(If this button is selected, attach the required exhibit and then go to question 7.)

[NOTE to questions 6: The following question applies only to major network affiliate stations selecting “Choice 5b” (i.e., the station will rely on another major network affiliate with regard to one or more of the three public interest related conditions below).]

6. Each major network affiliate station that intends to rely on other local major network affiliates to comply with one or more of the following three public interest related conditions for analog termination must select one option in each of the following three sections, below. You are not required to comply with the obligations below until more than 10% of the population in your Grade B analog contour loses full major network affiliate analog service.

A) Continuing Analog Service

Select the one button that applies:

◦ Licensee CERTIFIES that, when required (as indicated above), and continuing until June 12, 2009, this station will itself provide enhanced nightlight service to at least 90% of the population in its Grade B analog contour.

◦ Licensee CERTIFIES that, when required (as indicated above), this station will rely on the following major network affiliated station(s) to provide enhanced nightlight service or a combination of enhanced nightlight service and continuing full analog television service to its analog viewers until June 12, 2009, and that the station(s) listed individually or collectively cover, at a minimum, 90% of the population in the Grade B analog contour of the above-referenced station: ____________ (List licensee name(s), call sign(s) and location(s).)

B) Consumer Referral Telephone Number(s)

The phone number and operating hours of the Consumer Referral Telephone Number, and operating entity’s name, are as follows:

Operating Entity’s Name: __________

Phone Number: __________

Operating Hours: __________

(List phone number and operating hours of the Consumer Referral Telephone Number, and operating entity’s name).

Select the one button that applies:

◦ Licensee CERTIFIES that, beginning on when required (as indicated above), and continuing until at least June 12, 2009, this station will itself operate and publicize a Consumer Referral Telephone Number for local viewers.

◦ Licensee CERTIFIES that, beginning when required (as indicated above), and continuing until at least June 12, 2009, this station will publicize and support the Consumer Referral Telephone Number(s) for local viewers that will be operated by the following licensee(s) or other entity: ____________ (List name(s) and, if a licensee, call sign(s) and city/state.)

C) Walk-In Help Center(s)

The location and operating hours of the Walk-In Help Center(s) are as follows:

Location Name: __________

Street Address: __________

Operating Hours: __________

(List street address and operating hours of the Walk-In Help Center(s).)

Select the one button that applies:

◦ Licensee CERTIFIES that, beginning when required (as indicated above), and continuing until at least June 12, 2009, this station will itself operate and publicize the above-referenced Walk-In Help Center(s) for local viewers.

◦ Licensee CERTIFIES that, beginning on when required (as indicated above), and continuing until at least June 12, 2009, this station will publicize and support the above-referenced Walk-In Help Center(s) for local viewers that will be operated by the following licensee(s) or other entity: ____________ (List name(s) and, if a licensee, call sign(s) and city/state.)

Go to question 7.

[NOTE to question 7: All filers must provide a consumer contact number to which the Commission can refer questions about the station’s television service.]

7. Consumer Referral Contact Number.

The consumer contact phone number and working hours for the above-referenced station are as follows:

Phone Number: __________

Business Hours: __________

(List local phone number and business hours for station.)

(Instructions: The contact telephone number provided must be staffed by persons with specific knowledge of the station’s service coverage. For example, they must be able to answer questions from viewers about reception and service loss.)

Go to question 8.

[NOTE to question 8: All filers must make the following certifications.]

8. REQUIRED FOR ALL STATIONS/ LICENSEE CERTIFICATIONS: Signature of Authorized Agent of Licensee.

Form 2

Drop down: REVOCATION OF EARLY ANALOG TERMINATION NOTIFICATION

1. Select the button below:

◦ The above-referenced station hereby WITHDRAWS its previous notification of early analog termination and will continue to provide full analog television service until June 12, 2009. Licensee CERTIFIES that such continuation of full analog service will not result in interference with another station that has been approved to commence early post-transition operations. Notwithstanding any certifications in the Analog Service Termination Notification, this station is no longer required to comply with the public interest related conditions⁴ for early analog termination set forth in the Commission Report and Order, FCC 09-19, adopted March 13, 2009.

(Note: Licensee response must be YES to withdraw the station’s early analog termination notification.)

YES, ___ (withdraw this station’s early analog termination notification)

NO ___ [Error if NO is selected.]

2.a. Statutory analog nightlight service. If the above-referenced station is determined by the FCC to be eligible to participate in the statutory analog nightlight program (i.e., for up to 30 days after the June 12, 2009 transition deadline), does the station intend to provide statutory analog nightlight service?

(Note: Statutory analog nightlight service must be provided for no more than 30 days, but no less than two weeks, after the June 12, 2009 transition deadline.)

YES ___ NO ___

2.b. If YES, the station will provide statutory analog nightlight service from June 13, 2009 until the following date, which must fall between June 26 and July 12, 2009, inclusive: MM/DD/2009.

1 HYPERLINK TO FOLLOWING TEXT: “For purposes of this form, a reduction of analog service affecting more than 10 percent of the population in a station’s service area, as represented by the predicted Grade B contour, will be treated as a termination.”

2 Make this text a hyperlink to the Public Interest Related Conditions for Early Analog Termination (to be provided with the March Order)

3 Make this text a hyperlink to the Public Interest Related Conditions for Early Analog Termination (to be provided with the March Order)

4 Make this text a hyperlink to the Public Interest Related Conditions for Early Analog Termination (to be provided with the March Order)