Form FCC Form 318 FCC Form 318 Application for Construction Permit for a Low Power FM B

Application for Construction Permit for a Low Power FM Broadcast Station; Report and Order in MM Docket No. 99-25 Creation of Low Power Radio Service; Sections 73.807, 73.809......

FCC 318 April 2013

Application for Construction Permit for a Low Power FM Broadcast Station; Report and Order in MM Docket No. 99-25 Creation of Low Power Radio Service

OMB: 3060-0920

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Federal Communications Commission
Washington, D.C. 20554

Not Yet Approved by OMB
3060-0920

INSTRUCTIONS FOR FCC FORM 318
APPLICATION FOR CONSTRUCTION PERMIT
FOR A LOW POWER FM BROADCAST STATION
GENERAL INSTRUCTIONS
INTRODUCTION

(1) Part 0
(2) Part 1
(3) Part 73

"Commission Organization"
"Practice and Procedure"
"Radio Broadcast Services"

A. This form, together with the associated instructions and
worksheets, are designed to provide you with sufficient
information to fully and accurately complete an
application for a construction permit for a low power FM
(LPFM) station. Ultimately, however, if you are awarded
a construction permit and license for a new LPFM station,
you will be required to know and comply with all of the
Commission’s rules and policies applicable to the LPFM
service.

Copies of the Commission’s rules may be purchased from
the Government Printing Office. Current prices may be
obtained from the GPO Customer Service Desk at (202)
512-1803. For payment by credit card, call (202) 5121800, M-F, 8 a.m. to 4 p.m. e.s.t; facsimile orders may be
placed by dialing (202) 518-2233, 24 hours a day. Payment
by check may be made to the Superintendent of Documents,
Attn: New Orders, P.O. Box 371954, Pittsburgh, PA
15250-7954.

B. FCC Form 318 is used to apply for authority to construct a
new LPFM broadcast station, to make changes in an
authorized LPFM broadcast station, or to amend a pending
Form 318 application. This application for a construction
permit is the first step in the licensing process. Following
completion of station construction you must file a separate
application for an FCC license, FCC Form 319.
Applications for new stations and major change proposals
must be filed during a window filing period announced by
the Commission in a public notice. All proposals for minor
changes to LPFM authorizations are also to be filed on this
form. See 47 C.F.R. Section 73.870. The application
consists of the following sections:

In addition, any rule in Title 47, including the LPFM rules
in Part 73, may be retrieved by rule section number via the
internet. Applicants may locate any rule in Parts 0, 1, and
73
at
http://ecfr.gpoaccess.gov/cgi/t/text/textidx?sid=beedc875cf08bb2ad471c10737fb7ad0&c=ecfr
&tpl=/ecfrbrowse/Title47/47tab_02.tpl.

I.
II.
III.
IV.
V.
VI.

General Information
Legal Information
Point System Factors
Involuntary Time-Share Information
Certification
LPFM Engineering Data and Preparer’s Certification
(for preparer of engineering sections of the
application)

All applicants must complete Sections I, II, V, and VI. In
Section II, however, applicants for major and minor
changes in authorized stations need fill out only Questions
1, 4, 6, 7, and 9.

D. Electronic Filing of Application Forms. Applicants
must file Form 318 electronically. The Commission has
developed an electronic version of this form that is
available on the Commission’s Web site. Each applicant
filing electronically will benefit from “error checks” in the
Form 318 computer software and obtain immediate
confirmation of the receipt of its application by the
Commission. The electronic version of this form can be
accessed through the Consolidated Database System
(CDBS) online electronic forms filing system, located at
the
following
site:
https://licensing.fcc.gov/prod/cdbs/forms/prod/cdbs_ef.
htm. Electronic filing instructions are available in the
CDBS User’s Guide. The Guide can be accessed from the
Commission’s
web
site
at
http://licensing.fcc.gov/prod/cdbs/forms/prod/cdbs_ug.
htm. Applicants may find it useful to download and print
a copy of the Guide for easy reference during application
preparation.

C. This form makes many references to the Commission’s
rules. Applicants should have on hand and be familiar with
current broadcast rules in Title 47 of the Code of Federal
Regulations (C.F.R.):

All previous edition obsolete.

FCC 318 Instructions

(Certification), Question 2 (Eligibility), Question 4
(Community-Based Criteria) and Question 8 (Unlicensed
Operation).

E. Electronic Filing of Amendments. Amendments to
previously filed applications must be filed electronically,
and must contain the following information to identify the
associated application:
J.
(1)
(2)
(3)
(4)
(5)

F.

Applicant’s name;
Call letters, or specify “NEW”;
Proposed channel number;
Proposed station location; and
File number of application being amended (if known)
or date of filing of application being amended (if file
number is unknown).

Defective Applications. Applicants should provide all
information requested by this application. If any portions of
the application are not applicable, the applicant should so
state. Defective or incomplete applications will be
returned without consideration. If the FCC inadvertently
accepts a defective or incomplete application, that
application may be dismissed. See 47 C.F.R. Section
73.3564(b).

The applicant or the applicant’s authorized legal
representative, if any, must sign the application.
Depending on the nature of the applicant, the application
should be signed as follows: if a corporation, by an
officer; if an unincorporated association, by a member
who is an officer (for an unincorporated educational
institution, this could be a school superintendent, officer
of the school board, or a university 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. If the application is filed
electronically, the signature will consist of the electronic
equivalent of the typed name of the individual.

SECTION I: GENERAL INFORMATION
G. Current Information. In accordance with 47 C.F.R.
Section 1.65, applicants have a continuing obligation to
advise the Commission, through amendments, of any
substantial and material changes in the information
furnished in this application. This requirement continues
until the Commission action on this application is no longer
subject to reconsideration by the Commission or review by
the Commission or any court.

A. Question 1: Applicant Name, etc. The name of the
applicant stated in Question 1 shall be the exact name of
the agency, board, institution, organization, corporation,
association, Tribe or governmental entity seeking the
authorization. Do not list the name of an individual.
Individuals are not eligible for LPFM licenses. The name
of the applicant must be stated exactly in Question 1. In
all other sections of this form, an abbreviated name may
be used to identify the applicant.

Certifications

State Abbreviation

H. This application requires applicants to certify compliance
with various statutory and regulatory requirements.
Detailed instructions and three worksheets provide
additional information regarding Commission rules and
policies. These materials are designed to track the
standards and criteria which the Commission applies to
determine compliance and to increase the reliability of
applicant certifications.
I.

Applicants should use only those State abbreviations
approved by the U.S. Postal Service.
Facility ID Number
The FCC assigns a unique facility identification number to
all authorized broadcast stations. New station applicants
should leave this box blank. Applicants for minor or
major changes can obtain facility ID numbers for their
authorized LPFM stations at the Commission’s website at
http://licensing.fcc.gov/prod/cdbs/pubacc/prod/cdbs_p
a.htm. You can also obtain your facility ID number by
calling (202) 418-2700. Further, the facility ID number is
included on all Commission authorizations and
correspondence.

This application is presented primarily in a "Yes/No"
certification format. However, it contains places for
submitting explanations and exhibits where necessary or
appropriate. Each certification, explanation and exhibit
constitutes a material representation. Applicants may only
mark the "Yes" certification when they are certain that the
response is correct. A "No" response is required if the
applicant is requesting a waiver of a pertinent rule and/or
policy, or where the applicant is uncertain that the
application fully satisfies the pertinent rule and/or policy. A
"No" response to a certification question for which an
exhibit can be submitted will not cause the immediate
dismissal of the application, provided that an appropriate
exhibit is completed. However, the application includes
several certifications for which an explanatory exhibit
cannot be submitted. These include Section II, Question 1

B. Question 2: Contact Representative. If the applicant is
represented by a representative or agent (for example, legal
counsel), that person's name, firm or company, and
telephone/electronic mail address may be specified here, at
the applicant’s option.
C. Question 3: Application Purpose. This question requires

2

that the applicant identify the purpose of the application and
provide certain information about the facilities proposed in
the FCC Form 318. Applicants for a new LPFM station
should check “New Station.”
Applicants updating
information on a previously filed but not yet granted
application for a new LPFM station should check
“Amendment to pending application.”

be used to advance their educational purpose. Applicants
should provide detailed descriptions of the nature of their
proposed station programming and, if possible, program
schedules. Applicants accredited by State departments of
education or recognized by regional and/or national
accrediting organizations should identify the accrediting
entities. Applicants also must submit complete copies of
the documents establishing their nonprofit status, such as
corporate charters or articles of incorporation. Applicants
that fail to provide these materials are subject to dismissal.

SECTION II: LEGAL INFORMATION

A nonprofit educational organization also can be a
private, nonprofit entity such as a nonprofit foundation,
corporation or association. Under the Commission’s
standards, these applicants must demonstrate both that
they have an educational purpose and how their proposed
station programming will be used to advance that purpose.
Applicants should provide detailed descriptions of the
nature of their proposed station programming and, if
possible, program schedules. Applicants also must submit
complete copies of the documents establishing their
nonprofit status, such as corporate charters or articles of
incorporation. Applicants that fail to provide these
materials are subject to dismissal.

A. Question 1: Certification. Each applicant is responsible
for the information that the application instructions and
worksheets convey. The Commission's licensing processes
are premised on the accuracy and reliability of applicant
certifications. Thus, each applicant must carefully review
all instructions and worksheet materials prior to completing
this application.
B. Question 2: Eligibility. Applicants for new LPFM
stations must certify their eligibility to own and operate an
LPFM station under Commission rules and regulations.
Each applicant must check one “Yes” box for this
question and must check “No” for the other two boxes.
An applicant must submit an explanatory exhibit in
connection with its Question 2 “Yes” response but should
not submit any explanatory exhibits in connection with its
Question 2 “No” responses.

Subsection 2(b): Tribes and Tribal Organizations. A
Tribe is any Indian or Alaska Native Tribe, band, nation,
pueblo, village or community which is recognized by the
federal government. See 47 C.F.R. Sections 73.853(c)
and 73.7000. A Tribal organization is a private nonprofit
entity such as a nonprofit foundation, corporation or
association that is 51 percent or more owned or controlled
by a Tribe or Tribes. Applicants should provide a
detailed description of the noncommercial nature of their
proposed station programming and, if possible, program
schedules. Applicants that are Tribal organizations should
explain which Tribe or Tribes own or control them.
Applicants that are Tribal organizations – incorporated or
unincorporated – also must submit complete copies of the
documents establishing their nonprofit status, such as
corporate charters or articles of incorporation. Applicants
that fail to provide these materials are subject to dismissal.

Subsection
2(a):
Nonprofit
Educational
Organizations. An applicant may be eligible for an
LPFM station authorization under 47 C.F.R. Section
73.503 of the Commission’s rules, which applies to LPFM
stations pursuant to 47 C.F.R. Section 73.801. 47 C.F.R.
Section 73.503 provides that a noncommercial
educational (“NCE”) FM broadcast station “will be
licensed only to a nonprofit educational organization and
upon showing that the station will be used for the
advancement of an educational program.” The three basic
NCE eligibility requirements are:
(1) nonprofit
educational organization; (2) an educational goal or
purpose; and (3) use of station programming to further
that educational purpose.
In considering these
requirements, emphasis is placed on proposed station
programs which are clearly educational in nature, i.e.,
actually involve teaching or instruction, whether for
formal credit or not. However, it is not necessary that the
proposed station’s programming be exclusively or even
primarily educational in nature.

Subsection 2(c): Public Safety Radio Service. State
and local governments and non-government entities may
be eligible for LPFM station authorizations because they
propose to provide public safety radio services under
Section 309(j)(2)(A) of the Communications Act of 1934,
as amended, 47 U.S.C. Section 309(j)(2)(A). In order to
qualify under this provision, an applicant must not be
organized for profit, must use the proposed LPFM station
for public safety radio services to protect the safety of life,
health, or property, and the services must not be made
commercially available to the public. 47 U.S.C. Section
309(j)(2)(A); see also 47 C.F.R. Sections 90.17, 90.23,
and 90.27. Applicants that are non-government entities –
incorporated or unincorporated – must submit complete
copies of the documents establishing their nonprofit

Individuals cannot qualify as organizational applicants. A
nonprofit educational organization can be a public entity
(such as a governmental agency) or a private, nonprofit
entity which operates a bona fide, full-time school in the
community where it proposes to operate. Under the
Commission’s standards, these organizations generally are
presumed to have an educational purpose, and need only
demonstrate how their proposed station programming will

3

status, such as corporate charters or articles of
incorporation. Applicants that fail to provide these
materials are subject to dismissal.

(4)

empowers the general partner to veto any admissions
of additional general partners admitted by vote of the
exempt limited partners;

C. Question 3: Parties to the Application. This question is
designed to identify all individuals who may be subject to
various FCC ownership rules and related statutory
restrictions. Specifically, as used in this application, the
term "party to the application" includes any individual or
entity whose ownership or positional interest in the
applicant is “attributable.” An “attributable interest” is an
ownership interest in or in relation to an applicant or
licensee which will give its holder that degree of influence
or control over the applicant or licensee sufficient to
implicate the Commission's multiple ownership rules. The
Commission’s policies and standards for attribution are
set forth below. You will be answering questions about
those individuals and entities listed in response to
Question 3 when you respond to various other questions.

(5)

prohibits any exempt limited partner from voting on
the removal of a general partner or limits this right to
situations where the general partner is subject to
bankruptcy proceedings, as described in Sections
402 (4)-(5) of the Revised Uniform Limited
Partnership Act, is adjudicated incompetent by a
court of competent jurisdiction, or is removed for
cause, as determined by an independent party;

(6)

bars any exempt limited partner from performing any
services to the limited partnership materially relating
to its media activities, with the exception of making
loans to, or acting as a surety for, the business; and

(7)

states, in express terms, that any exempt limited
partner is prohibited from becoming actively
involved in the management or operation of the
media businesses of the partnership.

Non-Stock Corporations or Other Non Stock Entities
The applicant, the parent and subsidiary entities of the
applicant, and the officers, directors, and governing board
members of the applicant and its parent and subsidiary
entities are considered to be parties to the application,
with the exceptions provided by 47 C.F.R. Section
73.858, which are set forth below.

Notwithstanding conformance of the partnership agreement
to these criteria, however, the requisite certification cannot
be made if the applicant has actual knowledge of a material
involvement of a limited partner in the management or
operation of the media-related businesses of the partnership.
In the event that the applicant cannot certify as to the
noninvolvement of a limited partner, the limited partner will
be considered as a party to this application.

Partnerships and Limited Partnerships
Partners and non-insulated limited partners are considered
to be parties to the application. A limited partner in a
limited partnership is considered to be insulated if the
limited partner is not materially involved, directly or
indirectly, in the management or operation of the mediarelated activities of the partnership, and the applicant so
certifies in response to subsection b of Question 3.
Sufficient insulation of a limited partner for purposes of
this certification is assured if the limited partnership
agreement:
(1)

Limited Liability Companies
The Commission treats an LLC as a limited partnership,
each of whose members is considered to be a party to the
application. However, where an LLC member is insulated
in the manner specified above with respect to a limited
partnership and where the relevant state statute authorizing
the LLC permits an LLC member to insulate itself in
accordance with the Commission's criteria, that LLC
member is not considered a party to the application. In such
a case, the applicant should certify "Yes" in response to
Section II, Question 3b.

specifies that any exempt limited partner (if not a
natural person, its directors, officers, partners, etc.)
cannot act as an employee of the limited partnership
if his or her functions, directly or indirectly, relate to
the media enterprises of the company;

(2)

bars any exempt limited partner from serving, in any
material capacity, as an independent contractor or
agent with respect to the partnership's media
enterprises;

(3)

restricts any exempted limited partner from
communicating with the licensee or the general
partner on matters pertaining to the day-to-day
operations of its business;

Stock Corporations
The Commission’s multiple ownership attribution policies
and standards apply to LPFM applicants and licensees that
are stock corporations, with the exceptions provided by 47
C.F.R. Section 73.858, which are set forth below.
Generally, the applicant, the parent and subsidiary entities
of the applicant, the officers, directors, and governing
board members of the applicant and its parent and
subsidiary entities, and holders of voting stock interests in
the applicant of 5 percent or more are considered to be
parties to the application.

4

a.

Voting stock interests. Voting stock interests of 5
percent or more of the issued and outstanding voting
stock of the applicant are attributable, unless the
interest is passive in nature, in which case voting
stock interests of 20 percent or more are attributable.
Worksheet 1b entitled “Non-Party Influence Over
Applicant” is provided to help determine whether an
interest is passive in nature for purposes of the
Commission’s attribution policies and standards.
Where the 5 percent stock owner is itself a
corporation, each of its stockholders, directors and
"executive" officers (president, vice-president,
secretary, treasurer or their equivalents) is considered a
party to this application UNLESS the applicant
submits as an exhibit a statement establishing that an
individual director or officer will not exercise authority
or influence in areas that will affect the applicant or the
station. In this statement, the applicant should identify
the individual by name and title, describe the
individual's duties and responsibilities, and explain the
manner in which such individual is insulated from the
corporate applicant and should not be attributed an
interest in the corporate applicant or considered a party
to this application. In addition, a person or entity
holding an ownership interest in the corporate
stockholder of the applicant is considered a party to
this application ONLY IF that interest, when
multiplied by the corporate stockholder's interest in the
applicant, would account for 5% or more of the issued
and outstanding voting stock of the applicant. For
example, where Corporation X owns stock accounting
for 25% of the applicant's votes, only Corporation X
shareholders holding 20 percent or more of the issued
and outstanding voting stock of Corporation X have a
5% or more indirect interest in the applicant (.25 x .20
= .05) and, therefore, are considered parties to this
application. In applying the multiplier, any entity
holding more than 50% of its subsidiary will be
considered a 100% owner. Where the 5% stock owner
is a partnership, each general partner and any limited
partner that is non-insulated, regardless of the
partnership interest, is considered a party to the
application.

b.

(1)

such entity exercises no influence or control over
the corporation, directly or indirectly; and

(2)

such entity has no representatives among the
officers and directors of the corporation.

Non-voting stock and debt interests. Non-voting
stock and debt interests may be attributable under the
Commission’s “equity-debt-plus” (EDP) attribution
standard. Under the EDP standard, the interest held,
aggregating both equity and debt, must exceed 33% of
the total asset value (all equity plus all debt) of the
applicant, a broadcast station licensee, cable television
system, daily newspaper or other media outlet subject
to the Commission's broadcast multiple ownership rules
AND the interest holder must either hold an
attributable interest in a media outlet in the same
market or supply over 15% of the total weekly
broadcast programming hours of the station in which
the interest is held. For example, if a full-power
broadcaster were to invest in an LPFM applicant and
the investment accounted for more than 33 percent of
the LPFM applicant’s total capitalization, the
investment would be attributable and would violate
the cross-ownership prohibition of 47 C.F.R. Section
73.860 of the Commission’s rules, which is discussed
below in the Instructions to Section II, Question 5.
Similarly, if a director of the same full-power
broadcaster were to act as an officer of the LPFM
applicant, the director would be attributed with both
stations and Section 73.860 would be violated.

Exceptions
Section 73.858 of the Commission’s rules establishes two
exceptions to the above-stated attribution policies and
standards applicable to LPFM station applicants.
Applicants relying on either of these attribution
exceptions should answer question 5b “No” and
provide an explanatory exhibit.
a.

Stock subject to stockholder cooperative voting
agreements accounting for 50% or more of the votes in
a corporate applicant will be treated as if held by a
single entity and any stockholder holding 5% or more
of the stock in that block is considered a party to this
application.
An investment company, insurance company or trust
department of a bank is not considered a party to this
application, and an applicant may properly certify that
such entity's interest is non-attributable, IF its
aggregated holding accounts for less than 20% of the
outstanding votes in the applicant AND IF:

5

Section 73.858(a). Under this provision, members of
the board of directors of the parent of an LPFM
applicant or licensee may hold otherwise attributable
interests in a broadcast licensee, daily newspaper or
cable television system subject to the Commission’s
multiple ownership rules and not have those interests
attributed to them for purposes of an LPFM station
application, provided that the board members
holding such interests recuse themselves from any
consideration of matters affecting the LPFM station.
Similarly, an officer or director of an LPFM applicant
or licensee may hold an otherwise attributable interest
in a broadcast licensee, daily newspaper or cable
television system if: (1) the LPFM applicant or
licensee entity is a multi-faceted organization, such as
a university; (2) the duties of the officer or director

are wholly unrelated to the LPFM station; and (3) the
officer or director recuses himself or herself from
consideration of any matters affecting the LPFM
station. The purpose of these exceptions is to permit
an entity, such as a university, to become a LPFM
station licensee, notwithstanding the fact that certain
members of the entity’s board hold attributable media
interests.
Applicants applying for LPFM station
licenses under this exception must submit an
explanatory exhibit in response to Question 5b
identifying the individuals with otherwise attributable
interests.
b.

(b)

have 75 percent of its board members residing
within 10 miles, for applicants in the top 50 urban
markets, or 20 miles, for applicants outside of the
top 50 urban markets, of the transmitting antenna
site proposed in its Application;

(d)

propose a public safety radio service and have
jurisdiction within the service area of the proposed
station.

E. Question 5: Ownership.
Question 5(a): Ownership of Other LPFM Stations.
The Commission generally prohibits common ownership
of LPFM stations. However, the Commission permits
common ownership of up to two LPFM stations by Tribes
or Tribal organizations, see 47 C.F.R. Section 73.855(b),
and permits common ownership of LPFM stations by
nonprofit organizations and governmental entities with a
public safety purpose if certain conditions are met. See 47
C.F.R. Section 73.855(c).
Question 5(b): Ownership of Other Media Interests.
The Commission permits a party to have an attributable
interest in one LPFM and up to two FM translator
stations. See 47 C.F.R. Section 73.860(b). It permits a
Tribal Applicant or a party with an attributable interest in
a Tribal Applicant to have an attributable interest in up to
two LPFM and four FM translator stations. See 47 C.F.R.
Section 73.860(c). With one exception, see 47 C.F.R.
Section 73.860(d), the Commission otherwise prohibits
cross-ownership of an LPFM station and any other media
interest (i.e., a daily newspaper of general circulation, a
cable television system; or any full power AM or FM
radio station, or full or low power television station). See
47 C.F.R. Section 73.860(a).

D. Question 4: Community-Based Criteria. Applicants
must certify that they are local to be eligible for LPFM
authorizations. An applicant must check “Yes” to one of
the certifications set forth in Question 4 to be eligible for
an LPFM license. An applicant should not submit an
explanatory exhibit in connection with its Question 4
“No” responses. To be deemed “local” for purposes of
the Commission’s rules, an applicant must:
be physically headquartered or have a campus within
10 miles, for applicants in the top 50 urban markets,
or 20 miles, for applicants outside of the top 50
urban markets, of the transmitting antenna site
proposed in its Application;

be a Tribe and have its Tribal Lands within the
service area of the proposed LPFM station; or be a
Tribal organization whose controlling Tribe(s)
has(have) its(their) Tribal Lands within the service
area of the proposed LPFM station;

or

Section 73.858(b). Under this provision a local
chapter of a national organization will not have the
attributable media interests of the national
organization attributed to it, provided that the local
chapter:
(1) is incorporated in its local area
separately from the national organization with which
it is affiliated; and (2) has a distinct local presence
and mission. To satisfy the second element of this
standard, an applicant must demonstrate that it has
significant membership within its local area and that
it has a local purpose that can be distinguished from
the purpose of the national organization with which it
is affiliated. For example, the purpose of raising
awareness of an an environmental issue like air or
water quality in the United States would not satisfy
the distinct local mission requirement, but the
purpose of raising awareness of an environmental
issue like air or water quality in a particular local area
would satisfy the distinct local mission requirement.
Applicants applying for LPFM station licenses under
this exception must submit an explanatory exhibit in
response to Question 5b demonstrating how they
meet the above-stated requirements.

(a)

(c)

If the applicant (or any party to the application) has an
attributable interest in a broadcast station or other media
outlet that is prohibited under the Commission’s crossownership rule, the applicant (or the party to the
application) must divest the interest prior to the
commencement of operations of the LPFM station. In
such circumstances, the applicant must respond “No” to
the certification required by Question 5b and submit an
explanatory exhibit identifying the broadcast station or
other media outlet in which the applicant (or the party to
the application) holds an attributable interest and setting
forth the applicant’s (or party’s) intention to divest such
interest.
If the applicant (or any party to the application) holds an
attributable interest in an application for a broadcast
station, and cross-ownership of that station and an LPFM
station is prohibited under the Commission’s crossownership rule, the applicant must check “No” and
provide an exhibit that includes the file numbers of the

6

pending applications.

applicant or in another broadcast station application and the
Commission, by specific ruling or by subsequent grant of
the application, found the adverse finding not to be
disqualifying, it need not be reported again and the assignee
may respond "Yes" to this question. However, an adverse
finding that has not been reported to the Commission and
considered in connection with a prior application would
require a "No" response.

Question 5(c): Immediate Family Members. The
applicant must certify compliance with the Commission’s
policies relating to the media interests of immediate
family members. Worksheet 1 to this application form is
provided to help applicants determine their compliance
with these Commission’s policies.

Where the response to Question 7 is "No," the applicant
must provide in an exhibit a full disclosure of the persons
and matters involved, including an identification of the
court or administrative body and the proceeding (by dates
and file numbers), and the disposition of the litigation.
Where the requisite information has been earlier disclosed
in connection with another pending application, or as
required by 47 C.F.R. Section 1.65(c), the applicant need
only provide an identification of that previous submission
by reference to the file number in the case of an application,
the call letters of the station regarding which the application
or Section 1.65 information was filed, and the date of filing.

Question 5(d):
Investor Insulation and NonParticipation of Non-Party Investors and Creditors.
This question is only relevant if:

F.



the applicant is a limited partnership or a limited
liability corporation that seeks to insulate from
attribution members or partners in accordance with
the Commission’s rules; or



the applicant has non-party investors, for example,
creditors, secured parties, or program suppliers, and
these investors have the capacity to influence the
decision-making of the applicant. If these issues are
relevant to the applicant you should review
Worksheet 1 to this application.

H. Question 8: Unlicensed Operation. Question 8 requires
the applicant to certify, under penalty of perjury, that
neither the applicant nor any party to the application has
engaged in any manner, individually or with other
persons, groups, or organizations, in the unlicensed
operation of any station in violation of Section 301 of the
Communications Act of 1934, as amended, 47 U.S.C.
Section 301.

Question 6: Character Issues. Question 6 only applies to
those applicants or parties identified in Question 3 that have
previously applied for a broadcast license. If neither the
applicant nor any party to the application has previously
applied for a license, you should check “Yes.” Specifically,
Question 6 asks an applicant to certify that neither it nor any
party to the application has had any interest in or connection
with an application that was or is the subject of unresolved
character issues. Where the response to Question 6 is
“No,” the applicant must submit an exhibit that includes an
identification of the party having had the interest, the call
letters and location of the station or file number of the
application or docket, and a description of the nature of the
interests or connection, including relevant dates. The
applicant should also fully explain why the unresolved
character issue is not an impediment to a grant of this
application.

Applicants checking “No” to Question 8 are ineligible
for a license to operate an LPFM station. In addition,
applicants are warned that submission of false or
misleading statements will subject applicants to fines,
revocation of license, and applicable criminal penalties.
I.

Question 9: Anti-Drug Abuse Act Certification. This
question requires the applicant to certify that neither it nor
any party to the application is subject to denial of federal
benefits pursuant to the Anti-Drug Abuse Act of 1988, 21
U.S.C. Section 862.

G. Question 7: Adverse Findings. An applicant must
disclose in response to Question 7 whether the applicant or
any party to the application has been the subject of a final
adverse finding with respect to certain relevant nonbroadcast matters. The Commission's character policies and
litigation reporting requirements for broadcast applicants
focus on misconduct which involves a violation of the
Communications Act of 1934, as amended, or a
Commission rule or policy and on the types of non-FCC
misconduct listed in the question 7 certification.

Section 5301 of the Anti-Drug Abuse Act of 1988 provides
federal and state court judges the discretion to deny federal
benefits to individuals convicted of offenses consisting of
the distribution or possession of controlled substances.
Federal benefits within the scope of the statute include FCC
authorizations. A "Yes" response to Question 9 constitutes
a certification that neither the applicant nor any party to this
application has been convicted of such an offense or, if it
has, it is not ineligible to receive the authorization sought by
this application because of Section 5301.

In responding to Question 7, the applicant should consider
any relevant adverse finding that occurred within the past
ten years. Where that adverse finding was fully disclosed to
the Commission in an application filed on behalf of this

With respect to this question only, the term "party to the
application" includes: if the applicant is a corporation or
unincorporated association, all officers, directors, or
persons holding 5 percent or more of the outstanding stock

7

or shares (voting and/or non-voting) of the applicant; all
members if a membership association; and if the applicant is
a partnership, all general partners and all limited partners,
including both insulated and non-insulated limited partners,
holding a 5 percent or more interest in the partnership.

Memorandum Opinion and Order on Reconsideration, 15
FCC Rcd 19208, 19246-47, at ¶¶ 97-100 (2000); Creation
of a Low Power Radio Service, Fifth Order on
Reconsideration and Sixth Report and Order, 57 Comm.
Reg. (P & F) 143 (2012).
Applicants may not enhance their comparative position
after the close of the filing window during which they
filed their applications. See 47 C.F.R. Section 73.871(b).
The Commission will not accept a showing or a
comparative pledge made after the close of such filing
window as a basis for awarding a point or points. For
instance, if an applicant certifies that it does not qualify
for a point or points under one of the point system factors
by answering “No” to one of the questions in Section III,
it cannot later amend its application to respond “Yes” to
that question. This is the case even if the applicant
actually would have qualified for the point or points it is
seeking at the time it filed the application. Similarly, if an
applicant certifies that it qualifies for a point or points
under one of the point system factors but fails to submit
the required documentation prior to the close of the filing
window during which it filed the application, the applicant
will not be awarded a point under that factor and will not
be permitted to submit the required documentation in an
amendment.

SECTION III: POINT SYSTEM FACTORS
A.

The Commission uses a point system to select among
conflicting, i.e., “mutually exclusive,” LPFM applications
filed in the same window. This section allows applicants
for new LPFM stations and for major changes to existing
LPFM authorizations to claim points under this selection
procedure.
LPFM new and/or major change applications are treated as
mutually exclusive where the applications are filed in the
same window and the simultaneous operation of the two
proposed stations would result in one (or both) stations
causing objectionable interference to the other. The
Commission makes this determination on the basis of the
LPFM station-to-station distance separation requirements
set forth at 47 C.F.R. Section 73.807. This rule establishes
minimum distance separation requirements to all other
stations, including minimum distance separations between
LPFM stations. In the case of LPFM-LPFM separations, 47
C.F.R. Section 73.807 specifies a minimum distance
separation
between stations operating on the same
frequency (also called co-channel) and also between those
stations operating on first-adjacent channels. For example,
if an LPFM station application specifies a frequency of 94.7
MHz, the Commission will determine whether co-channel
proposals on 94.7 or first-adjacent channel proposals on
94.5 and 94.9 MHz meet the minimum separation
requirements of 24 and 14 kilometers, respectively.
Applications that do not meet these minimums will be
treated as mutually exclusive to each other and to any
application that is directly or indirectly mutually exclusive
to it or the other application. In these cases, the
Commission will use the point system selection procedure
to select one or more applications for grant.

B.

Mutually exclusive applications will be awarded a point
for each of the six criteria set forth below. Applicants
may claim the point(s) for which they qualify by certifying
“Yes” in response to the question and, in connection with
Questions 1 and 3 only, by submitting the documentation
or information set forth below. The applicant with the
highest point total in its mutually exclusive group will be
the tentative selectee, unless the mutual exclusivity is
resolved by settlement pursuant to 47 C.F.R. Section
73.872(e). Applicants tied for the highest point total in a
mutually exclusive group will be subject to voluntary and
involuntary timesharing. For more information, see 47
C.F.R. Section 73.872; Creation of a Low Power Radio
Service, Report and Order, 15 FCC Rcd 2205, 2260-64, at
¶¶ 139-151, Creation of a Low Power Radio Service,

Question 1: Established Community Presence. To
qualify for a point under this criterion, the applicant must
have an established community presence of at least two
years’ duration in the community that it proposes to serve.
A nonprofit educational organization applicant must be
able to certify that, during the two years prior to
application, (a) it has been in existence as a nonprofit
educational organization, and (b) has been physically
headquartered, has had a campus, or has had 75 percent of
its governing board members residing within 10 miles, for
applicants in the top 50 urban markets, or 20 miles, for
applicants outside of the top 50 urban markets, of the
coordinates of the proposed transmitting antenna. A
Tribal Applicant only must be able to certify that it is a
Tribe and that its Tribal Lands are within the service area
of the proposed LPFM station; or that it is a Tribal
organization whose controlling Tribe(s) has its(their)
Tribal Lands within the service area of the proposed
LPFM station. Tribal organizations created by a Tribe (or
Tribes) to apply for a LPFM construction permit need not
have been in existence for two years. A public safety
radio service applicant only must be able to certify that
during the two years prior to application it had jurisdiction
within the service area of the proposed LPFM station.
Nonprofit educational organizations claiming a point for
this criterion must submit evidence of their qualifications
as an exhibit to their application forms. This evidence
must demonstrate the date of commencement of the
applicant’s existence and the location(s) of the applicant’s
headquarters, campus, or governing board members’

8

residences (or, for governmental public safety radio
service applicants, the area of jurisdiction) during the two
years prior to the application filing. For example, such
evidence may consist of copies of corporate charters,
articles of incorporation, association, or partnership, or
other written instruments filed with the appropriate
governmental agency (e.g., Secretary of State)
documenting the applicant’s period of existence. The
location of an applicant’s headquarters, campus, or
governing board members’ residences may be
demonstrated by the submission of statements supported
by the affidavit or declaration of a person or persons with
personal knowledge thereof. See 47 C.F.R. Section 1.16.

applicant must certify that it qualifies for a point under
both the local program origination and the main studio
criteria. The applicant must have answered “Yes” to
Questions 2 and 3 of Section III.
F.

Question 5: Diversity of ownership. To qualify for a
point under this criterion, an applicant must certify that
neither it nor any party to the application holds an
attributable interest in any other broadcast station. We
remind applicants of their obligations under 47 C.F.R.
Section 1.65 to update their applications if they acquire an
attributable interest in another broadcast station.

G. Question 6: Tribes or Tribal organizations serving
Tribal lands. To qualify for a point under this criterion,
an applicant must be a Tribe proposing to locate its
transmitting antenna site on its Tribal Lands, or a Tribal
organization proposing to locate its transmitting antenna
site on the Tribal Lands of the Tribe or Tribes that own or
control more than 51 percent of the organization. See 47
C.F.R. Section 73.872(b)(6).

C. Question 2: Local program origination. To qualify for
a point under this criterion, applicants must pledge to
originate locally at least eight hours of programming per
day. Local origination is the production of programming
by the licensee, within ten miles of the coordinates of the
proposed transmitting antenna. Local origination includes
licensee produced call-in shows, music selected and
played by a disc jockey present on site, broadcasts of
events at local schools, and broadcasts of musical
performances at a local studio or festival, whether
recorded or live. Local origination does not include the
broadcast of repetitive or automated programs or timeshifted recordings of non-local programming whatever its
source. In addition, local origination does not include a
local program that previously has been broadcast twice,
even if the licensee broadcasts the program on a different
day or makes small variations in the program thereafter.

SECTION
IV:
INFORMATION

INVOLUNTARY

TIME-SHARE

A. If a tie among mutually exclusive LPFM applications
remains after the Commission conducts a points analysis,
the Commission offers the tied applicants the opportunity to
enter into a voluntary time-share agreement. If those
applicants do not enter into a voluntary time-share
agreement, the Commission will review the tied applications
to determine if they are acceptable for filing.

Applicants that claim points for this criterion will be
required to adhere to their pledges. The Commission will
use random audits to verify such adherence, and also will
consider written complaints. The Commission staff may
issue letters of inquiry requiring submission of
documentation in connection with such audits. Applicants
that fail to fulfill their pledges will be subject to
administrative sanctions including the possibility of
monetary forfeitures and revocation proceedings.

If there are three or fewer tied and grantable applications,
the Commission will grant these three applications,
assigning an equal number of hours per week to each
applicant.
The Commission will determine the hours
assigned to each applicant by first assigning hours to the
applicant that has been local for the longest uninterrupted
period of time, then assigning hours to the applicant has
been local for the next longest uninterrupted period of time,
etc.

D. Question 3: Main studio. To qualify for a point under
this criterion, applicants must pledge to maintain a
publicly accessible main studio that has local program
origination capability, is reachable by telephone, is staffed
at least 20 hours per week between 7 a.m. and 10 p.m.,
and is located within 10 miles of the proposed site for the
transmitting antenna for applicants in the top 50 urban
markets or 20 miles for applicants outside the top 50
urban markets.

If there are more than three tied and grantable applications,
the Commission will dismiss all but the applications of the
three applicants that have been local for the longest
uninterrupted periods of time. The Commission then will
process the remaining three applications as discussed above.
B. Question 1: Established Community Presence. In order
to allow the Commission to determine which applicants
have been local for the longest uninterrupted periods of
time, applicants must indicate the date on which they first
qualified as local. An applicant also must certify that it has
remained local at all times since the date indicated in
response to Question 1.

Applicants claiming a point under this criterion must
specify the address and telephone number for the
proposed main studio in response to this question.
E. Question 4: Local program origination and main
studio. To qualify for a point under this criterion, an

SECTION

9

VI:

LPFM

ENGINEERING

AND

PREPARER'S CERTIFICATION
Question 2: Antenna Location Coordinates. The
proposed antenna site must be specified using North
American Datum 27 (NAD 27) coordinates. Indicate North
or South Latitude, and East or West Longitude. Applicants
can determine coordinates with a 7.5 minutes series U.S.
Geological Survey topographic quadrangle map.

A. General Instructions for Section V. The engineering
section contains a "Tech Box" in which the applicant
specifies all technical data required for engineering review.
In the event that there are any discrepancies between data in
the "Tech Box" and data submitted elsewhere in the
application, the data in the "Tech Box" will be controlling.

The latitude and longitude coordinates for all points in the
United States for this LPFM service are based upon the
1927 North American Datum (NAD 27). The National
Geodetic Survey is in the process of replacing NAD 27 with
the more accurate 1983 North American Datum (NAD 83)
and updating current topographic maps. In addition,
coordinates determined by use of the satellite-based Global
Positioning System already reflect the NAD 83 datum. To
prevent intermixing of data from these two sources, the
Commission has announced that, until further notice, all
LPFM applicants are to furnish coordinates based on NAD
27 datum on all submissions and the Commission will
continue to specify NAD 27 coordinates in its data bases
and authorizations. Applicants may access a simple
computer program to convert NAD 83 coordinates to NAD
27
coordinates
at
http://www.ngs.noaa.gov/cgibin/nadcon.prl.

Applicants are not required to provide specific transmitter
make and model information on FCC Form 318. Rather,
the permit authorizing construction will require installation
of a FCC certified transmitter in compliance with the
provisions of 47 C.F.R. Section 73.1660. Applicants also
are not required to list the specific antenna make,
manufacturer, model number and number of bays for FM
antennae on FCC Form 318. That data is submitted
following the completion of construction in an application
for covering license (FCC Form 319).
B. Notifications. All applicants must comply with the
requirements of 47 C.F.R. Section 73.1030. Specifically,
applicants within affected areas must notify United States
Government radio astronomy installations, radio receiving
installations, and FCC monitoring stations of the proposed
facility and its possible impact on their operations. See 47
C.F.R. Section 73.1030. Affected facilities requiring
written notification at the time the LPFM application is filed
include radio astronomy observatories located in Arecibo,
Puerto Rico, and Green Bank, West Virginia, and the Table
Mountain Radio Receiving Zone in Boulder County,
Colorado. The written notification should be sent to the
appropriate address listed in 47 C.F.R. Section 73.1030 and
should include antenna height and coordinates, frequency
and power. The staff will coordinate applications with the
Commission’s Enforcement Bureau when there is the
potential for an adverse effect on an FCC monitoring
station. However, prior notice to the Enforcement Bureau is
suggested when an applicant believes its facility may affect
a monitoring station in the manner described in 47 C.F.R.
Section 73.1030. The Commission need not be informed of
the date of any notification.
C.

Question 3: Antenna Structure Registration Number.
The Antenna Structure Registration number should be
entered here. Most towers greater than 61 meters (200 feet)
in height and those located near airports require antenna
registration numbers. See 47 C.F.R. Section 17.4. If the
tower does not require registration, indicate that registration
is “Not Applicable,” or if the FAA has not yet determined
whether a proposed structure would be a hazard, indicate
whether the FAA Notification has been filed with the FAA.
For more information regarding the Commission’s antenna
structure registration requirements, applicants may review
the Wireless Telecommunications Bureau’s Antenna
Structure
Registration
web
site
at
http://wireless.fcc.gov/antenna/index.htm?job=home.
Questions 4-6: Elevation and Heights. All heights must
be in meters, rounded to the nearest whole number.

Tech Box. The applicant must accurately specify the
requested facilities in Questions 1 through 7 of the Tech
Box. Conflicting data found elsewhere in the application
will be disregarded. All Questions must be completed.
The response "on file" is not acceptable. The response "not
applicable" is not acceptable unless otherwise noted below.

Question 7: Power and Height Limitations. The staff
will determine an LPFM station’s antenna height above
average terrain (HAAT) from the Tech Box data for
coordinates, site elevation, and antenna radiation center
above ground level. The effective radiated power (ERP)
specified on the LPFM construction permit authorization
will be given in a range that, when considered with the staffcalculated HAAT, would allow operation within the
maximum and minimum ERP for LPFM stations. See 47
C.F.R. Section 73.811.

Question 1: Channel. The proposed channel must be
between 201 and 300. See 47 C.F.R. Section 73.805.
Applicants can determine which frequencies, if any, are
available at any specific set of coordinates within the United
States and its territories by using a simple computer
program available at the Audio Division web-page
http://www.fcc.gov/encyclopedia/low-power-fm-lpfmchannel-finder.

D. Certifications. Questions 8-10 set forth a series of
certifications concerning the Commission's technical
standards and operational requirements for LPFM stations.

10

In this regard, applicants are required to consider eight
environmental factors. These factors are listed in the
attached
General
Environmental
Worksheet
(Worksheet 2).

Question 8(a): Interference. The applicant must certify
that the proposal complies with the spacing provisions
contained in 47 C.F.R. Section 73.807. If the proposed
facility will be fully-spaced under 47 C.F.R. Section
73.807, the applicant should respond “Yes” to Question
8.a. If the proposed facility will be short-spaced under
Section 73.807, the applicant should respond “No” to
Question 8.a.

Should the applicant be unable to conclude that its
proposal will have no significant impact on the quality
of the human environment, it must submit an
Environmental Assessment containing the following
information:

If an applicant responds “No” to Question 8.a. and seeks a
waiver of the second-adjacent channel minimum distance
separation requirements, the applicant should include an
exhibit that provides sufficient information to demonstrate
that the proposed facility complies with the secondadjacent channel waiver standard. In other words, the
applicant must demonstrate that the proposed LPFM
facility will not cause interference to any authorized radio
service. An applicant may do so by showing a “lack of
population” in the area of predicted interference and may
use an undesired/desired signal strength ratio
methodology to define the area of potential interference.
An applicant seeking a second-adjacent waiver also may
use a directional antenna to show compliance with the
second-adjacent channel waiver standard. If an applicant
proposes to use a directional antenna, it must include an
exhibit that tabulates the Relative Field pattern of the
directional antenna for 36 evenly-spaced radials.
Question 8(b): Interference to Translator or Booster
Input Signals. In cases where 47 C.F.R. Section
73.827(a) is applicable, the applicant must certify that the
proposal complies with distance separation requirements
or demonstrate that “no actual interference” would occur
based on either the signal strength ratio showing or
minimum distance separation formula set forth in the rule.
In cases where 47 C.F.R. Section 73.827(a) is not
applicable, applicants should certify “N/A.”
Question 9: TV Channel Six Interference.
If the
proposed facility specifies operation on Channels 201-220,
the applicant must certify that the proposal complies with
the Channel Six spacing provisions contained in 47 C.F.R.
Section 73.825.

b.

Question 10: National Environmental Policy Act:
a.

Environmental Impact. The National Environmental
Policy Act of 1969 requires all federal agencies to
ensure that the human environment is given
consideration in all agency decision-making. Since
January 1, 1986, applications for new broadcast
stations, modifications of existing stations, and license
renewals must include either an environmental
assessment that will serve as the basis for further
Commission review and action, or a certification that
operation of the station will not have a significant
environmental impact. See 47 C.F.R. Section 1.1307.

11

(1)

A description of the facilities as well as
supporting structures and appurtenances, and a
description of the site as well as the surrounding
area and uses. If high-intensity white lighting is
proposed or utilized within a residential area, the
EA must also address the impact of this lighting
upon the residents.

(2)

A statement as to the zoning classification of the
site, and communications with, or proceedings
before and determinations (if any) by zoning,
planning, environmental and other local, state, or
federal authorities on matters relating to
environmental effects.

(3)

A statement as to whether construction of the
facilities has been a source of controversy on
environmental grounds in the local community.

(4)

A discussion of environmental and other
considerations that led to the selection of the
particular site and, if relevant, the particular
facility; the nature and extent of any unavoidable
adverse environmental effects; and any
alternative sites or facilities that have been or
reasonably might be considered.

(5)

If relevant, a statement why the site cannot meet
the FCC guidelines for RF exposure with respect
to the public and workers.

RF Exposure Guidelines. In 1996, the Commission
modified its guidelines and procedures for evaluating
environmental effects of RF emissions. All LPFM
station applications subject to environmental
processing must demonstrate compliance with the new
requirements. The new guidelines are explained in
more detail in OET Bulletin 65, entitled Evaluating
Compliance with FCC Guidelines for Human Exposure
to Radiofrequency Electromagnetic Fields, Edition 9701, released August, 1997, and Supplement A:
Additional Information for Radio and Television
Broadcast Stations (referred to here as "OET Bulletin
65" and "Supplement A," respectively). Both OET
Bulletin 65 and Supplement A can be viewed and/or
downloaded from the FCC Internet site at
http://transition.fcc.gov/oet/rfsafety/.
Copies can

also be purchased from the Commission's
duplicating/research
contractor,
International
Transcription Services, Inc., 1231 20th Street, N.W.,
Washington, D.C. 20036 (telephone: (202) 857-3800;
fax: (202) 857-3805). Additional information may be
obtained from the RF Safety Group at
[email protected] or (202) 418-2464 or from the FCC
Call Center at 1-888-CALL FCC (225-5322).
c.

technical data supplied.
The Section VI preparer's
certification need not be completed if the engineering
portion of the application has been prepared by the
applicant. In that event, the applicant's Section V, page 5
certification will cover the information provided in both the
legal and engineering sections of the application.

FCC NOTICE REQUIRED BY THE PAPERWORK
REDUCTION ACT

Worksheets. Worksheets 2 and 3 are designed to
facilitate and substantiate the certification called for
in Section V, Question 10.
The General
Environmental Worksheet (Worksheet 2) should be
used by all applicants. The RF Exposure Worksheet
(Worksheet 3) will assist the applicant in completing
the required radiofrequency (RF) electromagnetic
field calculations to determine whether the proposed
station adequately protects the public and workers
from potentially harmful RF fields.

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 45 minutes to 6 hours. 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 burden estimate, or on how we can improve
the collection and reduce the burden it causes you, please email them to [email protected] or send them to the Federal
Communications Commission, AMD-PERM, Paperwork
Reduction Project (3060-0920), Washington, DC 20554.
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 3060-0920.

Some, but not all, stations will be able to use the RF
Exposure Worksheet. The RF Exposure Worksheet
allows the applicant to determine if its LPFM station
would meet the Commission’s RF guidelines based
upon the facility’s antenna height above ground level.
Section One of the RF Exposure Worksheet is
applicable to an LPFM station that is the only RF
source on the only supporting structure in the area.
Such a facility may not exceed the Commission’s RF
limit. Section Two of the RF Exposure Worksheet
applies to an LPFM station that is one of several RF
sources at a site. In this case, the LPFM is excluded
from a detailed showing of compliance if it does not
contribute more that 5% of the Commission’s RF limit.
Applicants that fail to meet these antenna height
requirements will need to utilize more complex
calculations or measurements to demonstrate
compliance and may require the assistance of a
qualified consulting engineer to determine whether
the proposed facility will meet the RF exposure
guidelines. RF levels may still be acceptable based on
a more detailed evaluation of a number of variables,
e.g., antenna radiation patterns or measurement data.
In that case, the applicant must submit an exhibit to the
application that explains why the proposed facility does
not exceed the RF radiation exposure guidelines at
locations where humans are likely to be present, and/or
describes measures or circumstances which will
prevent or discourage humans from entering those
areas where the RF exposure exceeds the guidelines,
e.g., fencing or remote location. The guidelines are
explained in more detail in OET Bulletin 65.

THE FOREGOING NOTICE IS REQUIRED BY THE
PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13,
OCTOBER 1, 1995, 44 U.S.C. 3507.

E. Preparer's Certification. When someone other than the
applicant has prepared the engineering section of the FCC
Form 318, Section V requires that person to certify, to the
best of his/her knowledge and belief, the veracity of the

12

WORKSHEETS FOR FCC FORM 318
APPLICATION FOR CONSTRUCTION PERMIT FOR A LOW POWER FM BROADCAST STATION
WORKSHEET #1a - FAMILY RELATIONSHIPS
This worksheet is for use in connection with Section II, Question 5c of FCC Form 318, which requires the applicant to certify that
the applicant and the parties to the application are in compliance with the Commission's policies relating to media interests of
immediate family members (i.e., husband, wife, father, mother, sister, brother, son and/or daughter). This worksheet need not be
submitted with the application and retention of this worksheet is not required. However, an applicant's ability to produce a copy
upon request may prove helpful in determining compliance with the Commission's rules and policies.
The Commission does not presume that media interests of immediate family members should be attributed to the applicant and the
parties to the application. This presumption, however, is rebuttable. Accordingly, the applicant should examine the media interests
of the principals' immediate family members to determine whether or not those media interests will be independent and not subject
to common influence or control See Policy Statement, Clarification of Commission's Policies Regarding Spousal Attribution, 7
FCC Rcd 1920 (1992); Sevier Valley Broadcasting, Inc., 10 FCC Rcd 9795 (1995). An applicant should review this worksheet if
the answer to the following question is "Yes":
Does any member of the immediate family (i.e., husband, wife, father, mother, sister, brother, son and/or
daughter) of any party to the application have any interest in or connection with any other broadcast
station, pending broadcast application, or daily newspaper in the same area?

Yes

No

For purposes of this policy, a low power FM and a full-service broadcast station are in the same area if the entire proposed area of
service of the low power FM station is encompassed by the full-service station's principal community coverage contour (2 mV/m
contour for AM stations; 1 mV/m (60 dBu) for FM stations, including FM translator stations and FM booster stations; Grade A
contour for TV stations, including TV translator stations and LPTV stations). A low power FM station and a daily newspaper are in
the same area if the low power FM station's proposed area of service encompasses the entire community in which the daily
newspaper is published. (A daily newspaper is one that is published four or more days per week, is in the dominant language in the
market, and is circulated generally in the community of publication. A college newspaper is not considered to be circulated
generally. See 47 C.F.R. Section 73.3555(d) and Note 6.) Two low power FM stations are considered to be in the same area if their
transmitting antennas are located within seven miles of one another.
If the answer to the above-stated question is "Yes," answer the following questions for each such relationship:
1.

Has the family member who is not included as a party to the application been involved
negotiations for the construction of the station?

in

Yes

No

2.

Has the family member who is not included as a party to the application provided financing or
otherwise been involved in the process of making financial arrangements for the construction of the
station?

Yes

No

3.

Is this the first broadcast ownership interest of the family member who is a party to the application?

Yes

No

4.

Are the family members involved together in the management or operation of any other media

Yes

No

5.

Are there any agreements, arrangements or understandings, either written or oral, between the
family members with same-area media interests for the participation of one family member in the
financial affairs, commercial practices, programming, or employment practices of the other family
member's media entity. Consider, for example, joint sales agreements, local marketing agreements,
and arrangements to share facilities or personnel.

Yes

No

If the applicant answers "No" to questions 1 through 5 above, the applicant may conclude that it is in compliance with the
Commission's policies relating to media interests of immediate family members. If the applicant answers "Yes" to any one of
questions 1 through 5 above, the applicant must answer "No" to Section II, Question 5c of FCC Form 318, and must submit an
explanatory exhibit providing a detailed statement regarding the business or media relationship involved between family members.
FCC 318 Worksheet 1a

WORKSHEET #1b - INVESTOR INSULATION AND NON-PARTY INFLUENCE OVER ASSIGNEE/APPLICANT
This section of the worksheet may be used in connection with Section II, question 5d of FCC
Form 318, which requires the
applicant to certify that it complies with the Commission's restrictions relating to the insulation and non-participation of no n-party
investors and creditors. See Review of the Commission's Regulations and Policies Affecting Investment in the Broadcast Industry,
14 FCC Rcd 12559 (1999). It indicates the kinds of contractual relationships that may, in the Commission's view, exceed the
authority of a properly insulated investor or demonstrate some indicia of de facto control by a creditor.
I. Investor Insulation
If an applicant is a limited partnership or a limited liability company ("LLC") that seeks to insulate partners or members in
accordance with the Commission's attribution rules, the applicant shall ensure that each such limited partner or LLC member is not
materially involved, directly or indirectly, in the management or operation of the media-related activities of the partnership or LLC.
To ensure that each such limited partner or LLC member is not materially involved, directly or indirectly, in the management or
operation of the media-related activities of the partnership or LLC, the applicant must answer the following inquiries. Do the
limited partnership or LLC enabling documents:
a.

specify that any exempt limited partner/LLC member (if not a natural person, its directors, officers,
partners, etc.) cannot act as an employee of the limited partnership/LLC member if his or her
functions, directly or indirectly, relate to the media enterprises of such entity?

Yes

No

b.

bar any exempt limited partner/LLC from serving, in any material capacity, as an independent
contractor or agent with respect to the partnership/LLC's media enterprises?

Yes

No

c.

restrict any exempt limited partner/LLC member from communicating with the limited
partnership/LLC, the general partner, or any LLC management committee on matters pertaining to
the day-to-day operations of its business?

Yes

No

d.

empower the general partner/LLC management committee to veto any admissions of additional
general partners/LLC members admitted by vote of the exempt limited partners/LLC members?

Yes

No

e.

prohibit any exempt limited partner/LLC member from voting on the removal of a general
partner/LLC member or limit this right to situations where the general partner/LLC member is (i)
subject to bankruptcy proceedings, as described in Section 402(4)-(5) of the Revised Uniform
Limited Partnership Act, (ii) is adjudicated incompetent by a court of competent jurisdiction, or (iii)
is removed for cause, as determined by an independent party?

Yes

No

f.

bar any exempt limited partner/LLC member from performing any services to the limited
partnership/LLC materially relating to its media activities, with the exception of making loans to, or
acting as a surety for, the business?

Yes

No

g.

state, in express terms, that any exempt limited partner/LLC member is prohibited from becoming
actively involved in the management or operation of the media businesses of the limited
partnership/LLC?

Yes

No

If the answer is "Yes" to each of these conditions with regard to every limited partner and LLC member
that the applicant seeks to insulate and the relevant state statute authorizing the LLC permits a LLC
member to insulate itself in accordance with the Commission's criteria, the applicant may certify that it
complies with the Commission's restrictions regarding insulation of non-party investors. If "No" to the
foregoing, the applicant must respond "No" to Section II, Item 5d of FCC Form 318 and submit an
explanatory exhibit detailing the rights of any non-party investor and setting forth the applicant's reasons
for not treating the investor as a party to the application.

FCC 318 Worksheet 1b

II. Non-Party Influence Over Applicant
A. Non-party investors, i.e., investors with nonattributable interests, may have very limited powers over the operations of a
licensee. Accordingly, with respect to any agreement, arrangement or understanding involving insulated parties or other investors
with nonattributable interests, including creditors, secured parties, program suppliers, and any other persons not disclosed as parties
to this application, does such agreement:
1.

give any non-party investor the right to vote on any matters decided by the applicant's board of
directors, partnership committee or other management group;

Yes

No

2.

give any non-party investor the right to attend, or appoint an observer to attend, applicant board,
partnership or other management meetings;

Yes

No

3.

place any limitation on applicant programming discretion;

Yes

No

4.

give any non-party investor the right to vote on, approve or restrict applicant's actions on any matter
relating to programming, personnel or finances;

Yes

No

5.

give any non-party creditor or any bond, debenture or warrant holder the right to vote on, approve
or restrict the applicant's actions on any matter relating to programming, personnel or finances;

Yes

No

6.

give any non-party investor that holds a non-voting convertible interest the right to convert such an
interest and acquire control of the
applicant based on the applicant's actions relating to
programming, personnel and finances;

Yes

No

7.

give any non-party investor, creditor, or bond, debenture or warrant holder the right to vote on,
approve or deny the selection or removal of a general partner of an applicant partnership or a
member of the applicant's governing body; and

Yes

No

8.

give any non-party investor, creditor, or bond, debenture or warrant holder the right to convert,
tender or require the tendering of stock pursuant to a put-or-call agreement based on the actions of
the applicant relating to programming, personnel or financing.

Yes

No

If the answer to all of these conditions is "No" with regard to every non-party investor and creditor, and
there are no other provisions that cede de facto control to a non-party, applicant may certify that it
complies with the Commission's restrictions regarding non-participation of non-party investors and
creditors. If the answer to any of these inquiries is "Yes," the applicant must respond "No" to Section II,
Item 5d of FCC Form 318 and submit an exhibit detailing the rights of any non-party investor and setting
forth the applicant's reasons for not treating the investor as a party to the application.

Yes

No

B. With respect to any loan agreement, has the applicant ensured that such agreement:
1.

includes an unconditional promise by the applicant to pay on demand or on a specific date a sum
certain;

Yes

No

2.

contains a fixed or defined variable rate of interest on the loan; and

Yes

No

3.

does not prohibit the redemption of the loan by the applicant, or permit redemption at the option of
the lender only?

Yes

No

If the answer to each of these inquiries is "Yes," and if there are no other provisions that may give
non-party investors control, the applicant may conclude that it complies with the Commission's
restrictions regarding non-participation of non-party investors and creditors. If not, the applicant must
respond "No" to Section II, Item 5d of FCC Form 318 and submit an exhibit detailing the rights of the
lender and the obligations of the applicant for each loan agreement.

FCC 318 Worksheet 1b (Page 2)

Federal Communications Commission
Washington, D. C. 20554

Approved by OMB
3060-0920

FCC 318
APPLICATION FOR CONSTRUCTION PERMIT
FOR A LOW POWER FM BROADCAST STATION

FOR
FCC
USE
ONLY

FOR COMMISSION USE ONLY
FILE NO.

Section I - General Information
Legal Name of the Applicant
1.

Mailing Address

City

State or Country (if foreign address)

Telephone Number (include area code)

E-Mail Address (if available)

Call Sign

2.

Contact Representative (if other than applicant)

ZIP Code

Facility ID Number

Firm or Company Name

Mailing Address

3.

City

State or Country (if foreign address)

Telephone Number (include area code)

E-Mail Address (if available)

ZIP Code

Application Purpose.
New station

Major modification of construction permit

Major change in licensed facility

Minor modification of construction permit

Minor change in licensed facility

Amendment to pending application

a. File number of original construction permit:
b. Station location:

City

N/A
State

If an amendment, submit as an Exhibit a listing by section and question number of the portions of
the pending application that are being revised.

Exhibit No.

FCC Form 318

NOTE: The failure to include an explanatory exhibit providing full particulars in connection with a ''No'' response may
result in dismissal of the application. See General Instructions, Paragraph I for additional information regarding the
completion of explanatory exhibits.
Section II - Legal
New LPFM station applicants must complete all questions in Section II. Major and minor change applicants must complete only
questions 1, 4, 6, 7 and 9.
1.

Certification. Applicant certifies that it has answered each question in this application
based on its review of the application instructions and worksheets. Applicant further
certifies that where it has made an affirmative certification below, this certification
constitutes its representation that the application satisfies each of the pertinent standards
and criteria set forth in the application, instructions, and worksheets.

2.

Eligibility. Each applicant must answer "Yes" to one and "No" to two of the three
following certifications. An applicant should not submit an explanatory exhibit in
connection with these Question 2 "No" responses.

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

The applicant certifies that:
a.
b.
c.

it is a nonprofit educational organization;
or
it is a Tribe or Tribal organization;
or
it is a state or local government or a non-government entity that proposes a
noncommercial public safety radio service to protect the safety of life, health, or
property.

If the answer to 2c is "Yes" and the applicant is submitting multiple applications, is this
application the "priority" application? See Creation of a Low Power Radio Service,
Memorandum Opinion and Order on Reconsideration, 15 FCC Rcd 19208, 19239-40,
79-80 (2000).
Note: An applicant that answers "Yes" to 2a. must include an exhibit that describes the
applicant's educational program and how its proposed station will be used to advance its
educational program. If the applicant is incorporated, the exhibit must include the state
and date of applicant's incorporation. If the applicant is unincorporated, the exhibit must
include the state in which it is registered or otherwise recognized and the date of such
registration or recognition.
An applicant answering "Yes" to 2b. must include an exhibit that specifies whether the
applicant is a Tribe or Tribal organization, and describes its proposed noncommercial
service. If the applicant is a Tribal organization and is incorporated, the exhibit also must
state which Tribe or Tribes own or control the applicant, and specify the state and date of
applicant's incorporation. If the applicant is a Tribal organization and is not incorporated,
the exhibit must state which Tribe or Tribes own or control the applicant, and specify the
state in which the applicant is registered or otherwise recognized and the date of such
registration or recognition.
An applicant that answers "Yes" to 2c. must include an exhibit that describes the
applicant's public safety radio program and how the proposed station will be used to
protect the safety of life, health or property. If the applicant is a non-governmental entity
and is incorporated, the exhibit must include the state and date of applicant's incorporation.
If the applicant is a non-governmental entity and is not incorporated, the exhibit must
include the state in which it is registered or otherwise recognized and the date of such
registration or recognition.

FCC Form 318 (Page 2)

N/A

Exhibit No.

3.

Parties to the Application.
a.

List separately each party to the application including, as applicable, the applicant, its officers, directors, five percent or
greater stockholders, non-insulated partners, members, and all other persons and entities with attributable interests. If a
corporation or partnership holds an attributable interest in the applicant, list separately, as applicable, its officers,
directors, five percent or greater stockholders, non-insulated partners, and board members. Create a separate row for
each individual or entity. Attach additional pages if necessary.
(3) Positional Interest: Officer, director, general
(1) Name and address of party.
partner, limited partner, LLC member, or
investor/creditor attributable under the
(2) Citizenship.
Commission's equity/debt plus standard.
(4) Percentage of votes.
(5) Percentage of total assets (equity plus debt).
(1)

(2)

(3)

b. Applicant certifies that equity and financial interests not set forth above are
non-attributable.

(4)

(5)

Yes
N/A

FCC Form 318 (Page 3)

No

See Explanation
in Exhibit No.

4.

Community-Based Criteria. The applicant certifies that:
a.

it is a nonprofit educational organization that is physically headquartered or has a
campus within 16.1 kilometers (10 miles), if applicant is in the top 50 urban markets,
or 32.1 kilometers (20 miles) if applicant is outside the top 50 urban markets, of the
proposed transmitting antenna site specified in this application.

b.

it is a nonprofit educational organization that has 75 percent of its board members
residing within 16.1 kilometers (10 miles), if applicant is in the top 50 urban markets,
or 32.1 kilometers (20 miles) if applicant is outside the top 50 urban markets, of the
proposed transmitting antenna site specified in this application.

c.

it is a Tribe and its Tribal Lands, as that term is defined in Section 73.7000 of the
Commission's rules, are within the service area of the proposed LPFM station; or it is
a Tribal organization owned or controlled by a Tribe (or Tribes) and such Tribe's (or
Tribes') Tribal Lands, as that term is defined in Section 73.7000 of the Commission's
rules, are within the service area of the proposed LPFM station. See 47 C.F.R.
Sections 73.853(c) and 73.7000.

d.

it proposes a public safety radio service and has jurisdiction within the service area of
the proposed LPFM station.

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No See Explanation

Note: An applicant should not submit an explanatory exhibit in connection with these
Question 4 "No" responses.
5.

Ownership.
a. Applicant certifies that it and all parties to the application comply with the multiple
ownership limits set forth in Section 73.855 of the Commission's rules. See 47 C.F.R.
Section 73.855.
b. Applicant certifies that it and all parties to the application comply with the
cross-ownership limits set forth in Section 73.860 of the Commission's rules. See 47
C.F.R. Section 73.860.
c. Applicant certifies that it and all parties to the application comply with the
Commission's policies relating to media interests of immediate family members; and
d. Applicant certifies that it and all parties to the application comply with the
Commission's policies relating to investor insulation and the non-participation of
non-party investors or creditors.

in Exhibit No.

Yes

No See Explanation
in Exhibit No.

Yes

No

Yes

No

FCC Form 318 (Page 4)

6.

7.

Character Issues. The applicant certifies that neither the applicant nor any party to the
application has or has had any interest in, or connection with:
a.

any broadcast application in any proceeding where character issues were left
unresolved or were resolved adversely against the applicant or party to the
application; or

b.

any pending broadcast application in which character issues have been raised.

Adverse Findings. The applicant certifies that no adverse finding has been made and no
adverse final action has been taken by any court or administrative body as to the applicant,
any party to this application, or any non-party equity owner in the applicant, in a civil or
criminal proceeding brought under the provisions of any law related to the following: any
felony; mass media related antitrust or unfair competition; fraudulent statements to another
governmental unit; or discrimination?
If the answer is ''No,'' attach as an Exhibit a full disclosure concerning the persons and
matters involved, including an identification of the court or administrative body and the
proceeding (by dates and file numbers), and a description of the disposition of the matter.
Where the requisite information has been earlier disclosed in connection with another
application or as required by 47 C.F.R. Section 1.65, the applicant need only provide: (i) an
identification of that previous submission by reference to the file number in the case of an
application, the call letters of the station regarding which the application or Section 1.65
information was filed, and the date of filing; and (ii) the disposition of the previously
reported matter.

8.

Unlicensed Operation. The applicant certifies, under penalty of perjury, that neither the
applicant nor any party to the application has engaged in any manner, individually or
with other persons, groups, organizations, or other entities, in the unlicensed operation of
any station in violation of Section 301 of the Communications Act of 1934, as amended,
47 U.S.C. Section 301.

9.

Anti-Drug Abuse Act Certification. Applicant certifies that neither the applicant nor any
party to the application is subject to denial of federal benefits pursuant to Section 5301 of
the Anti-Drug Abuse Act of 1988, 21 U.S.C. Section 862.

FCC Form 318 (Page 5)

Yes

No

Yes

No

Exhibit No.

Yes

Yes

No

No

See Explanation
in Exhibit No.

Section III - Point System Factors
New station and major change applicants must complete the following questions.
Point system factors are used only for selection among mutually exclusive applications for new LPFM stations and major
modification of authorized LPFM stations. Mutually exclusive applicants will be awarded a point for each of the following:
1.

Established community presence.
a. Nonprofit educational organizations. The applicant certifies that, for a period of at
least two years prior to the date of this application, it has existed as a nonprofit
educational organization and has been physically headquartered, has had a campus, or
has had seventy-five percent of its board members residing within 16.1 kilometers
(10 miles), for the top 50 urban markets, or 32.1 kilometers (20 miles), outside the
top 50 urban markets, of the coordinates of the proposed transmitting antenna.
An applicant claiming a point under 1a. must submit an exhibit documenting its
established community presence. See instructions.
b. Tribes and Tribal organizations. The applicant certifies that it is a Tribe and that
its Tribal Lands are within the service area of the proposed LPFM station; or that it is
a Tribal organization owned or controlled by a Tribe (or Tribes) and its (or their)
Tribal Lands are within the service area of the proposed LPFM station.
c. Public safety radio service. The applicant certifies that, for a period of at least two
years prior to the date of this application, it has had jurisdiction within the service
area of the proposed public safety radio service LPFM station.

2.

Local program origination. The applicant pledges to originate locally at least eight
hours of programming per day.

3.

Main studio. The applicant pledges to maintain a publicly accessible main studio that has
local program origination capability, is reachable by telephone, is staffed at least 20 hours
per week between 7 a.m. and 10 p.m., and is located within 16.1 kilometers (10 miles) of
the proposed site for the transmitting antenna for applicants in the top 50 urban markets
and 32.1 kilometers (20 miles) for applicants outside the top 50 urban markets.

Yes

No

Exhibit No.

Yes

No

Yes

No

Yes

No

Yes

No

An applicant claiming a point under 3. must provide the proposed address and telephone
number for the main studio.
Address:

Telephone:

4.

Local program origination and main studio. The applicant certifies that it qualifies for
a point under both the local program origination and the main studio criteria.

Yes

No

5.

Diversity of ownership. The applicant certifies that neither it nor any party to the
application holds an attributable interest in any other broadcast station.

Yes

No

6.

Tribes or Tribal organizations. The applicant certifies it is a Tribe proposing to locate
its transmitting antenna site on its Tribal Lands, or a Tribal organization proposing to
locate its transmitting antenna site on the Tribal Lands of the Tribe or Tribes that own or
control more than 51 percent of the organization.

Yes

No

FCC Form 318 (Page 6)

Section IV - Involuntary Time-Share Information
New station and major change applicants must complete the following questions.
This information will be used only for selection among mutually exclusive applications for new LPFM stations and major
modification of authorized LPFM stations and only in the event that two or more applications are tied after the point analysis.
See 47 C.F.R. Section 73.872.
1.

Established Community Presence: Provide the date on which the applicant qualified
as local. See 47 C.F.R. Section 73.853(b).
Applicant certifies that it has remained local at all times since this date.

Yes

No

Section V - Certification
The applicant certifies that the statements in this application are true, complete, and correct to the best of its knowledge and belief,
and are made in good faith.
The applicant acknowledges that all certifications and attached Exhibits are considered material representations.
The applicant acknowledges that the submission of false or misleading statements will subject the applicant to fines, revocation of
license(s), and applicable criminal penalties.
The applicant hereby waives any claim to the use of any particular frequency as against the regulatory power of the United States
because of the previous use of the same, whether by licensee or otherwise, and requests an authorization in accordance with this
application. (See Section 304 of the Communications Act of 1934, as amended.)
Typed or Printed Name of Person Signing

Typed or Printed Title of Person Signing

Signature

Date

FCC Form 318 (Page 7)

Section VI - LPFM Engineering, Tech Box
TECHNICAL SPECIFICATIONS Applicants must list technical specifications accurately. Contradictory data found elsewhere
in this application will be disregarded. All items must be completed. The response ''on file'' is not acceptable.

TECH BOX
1.

Channel:

2.

Antenna Location Coordinates: (NAD 27)
0
'

"

'

"

0

3.

N

S Latitude

E

W Longitude

Antenna Structure Registration Number:
Not applicable

FAA Notification Filed with FAA

4.

Antenna Location Site Elevation Above Mean Sea Level:

meters

5.

Overall Tower Height Above Ground Level:

meters

6.

Height of Antenna Radiation Center Above Ground Level:

meters

7.

Power and height limitations. By checking ''Yes'', the applicant acknowledges that it will be
authorized to operate within the parameters defined in 47 C.F.R. Section 73.81 1 as calculated
based on the data specified herein.

Yes

No

An explanatory exhibit providing full particulars must be submitted for each question for which a ''No'' response is provided.

8.

a. Interference. The applicant certifies that the proposed facility complies with all
pertinent distance separation requirements of 47 C.F.R. Section 73.807.

Yes

No

See Explanation
in Exhibit No.

Yes

No

See Explanation
in Exhibit No.

Note: New station applications that fail to meet all of the co-channel and first-adjacent
channel separation requirements set forth in 47 C.F.R. Section 73.807 will be returned
and will not be provided an opportunity to file a curative amendment.
An applicant seeking a waiver of second-adjacent channel minimum distance
separation requirements must submit an exhibit demonstrating that the proposed station
operations will not result in interference to any authorized radio service. See
instructions for additional information.
b. Interference to Translator or Booster Input Signals. The applicant certifies that the
proposed facility complies with all pertinent requirements of 47 C.F.R. Section
73.827(a).
Note: Where Section 73.827(a) is applicable, an applicant must certify that the
proposed facility complies with the distance separation requirements set forth in that
section or demonstrate that "no actual interference" would occur based on either the
signal strength ratio showing or minimum distance separation formula set forth in 47
C.F.R. Section 73.827(a) or an alternative technical arrangement agreed to by both the
applicant and the affected FM translator or FM booster station.

FCC Form 318 (Page 8)

N/A

TV Channel 6 Interference (Channel 201-220). The applicant certifies that the proposed
facility complies with 47 C.F.R. Section 73.825.

9.

Yes

No

See Explanation
in Exhibit No.

No

See Explanation
in Exhibit No.

N/A

National Environmental Policy Act. The applicant certifies, based on its completion of
Worksheets 2 and 3 and its review of the instructions to this application, that the proposed
facility is excluded from environmental processing under 47 C.F.R. Section 1.1306 (i.e.,
the facility will not have a significant environmental impact and complies with the
maximum permissible radio frequency electromagnetic exposure limits for controlled and
uncontrolled environments). Unless the applicant can determine compliance through the
use of the attached General Environmental and RF Exposure Worksheets, an Exhibit is
required.

10.

Yes

THE FOLLOWING PREPARER'S CERTIFICATION MUST BE COMPLETED AND SIGNED.

PREPARER'S CERTIFICATION
I certify that I have prepared Section V (Engineering Data) on behalf of the applicant, and that after such preparation, I have
examined and found it to be accurate and true to the best of my knowledge and belief.
Name

Relationship to Applicant (e.g., Consulting Engineer)

Signature

Date

Mailing Address
City

State or Country (if foreign address)

Telephone Number (include area code)

E-Mail Address (if available)

ZIP Code

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).

FCC Form 318 (Page 9)


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