Form FCC Form 442 FCC Form 442 Application for New or Modified Radio Station Authorizat

,$?proved by

OMB

FEDERAL COMMUNICATIONS COMMISSION

21060-0065

USE
ONLY

FCC FORM 442

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APPLICATION FOR NEW OR MODIFIED RADIO STATION' AUTHORIZATION UNDER' PART 6
OF FCC RULES
EXPERIMENTAL RADIO SERVICE [OTHER THAN BROADCAST)

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I-

IVIAILINGADDREFS (Line 1) ( M a x i m u m

sij charaoterrr - refer -to Instruction 0 on reverse of

form)

I

CITY

ZIP CODE

:STATE OR COUNTRY (if f o r e i g n address)

CALL SIGN OR FILE NUMBER

--Enter In Calm (A). the correct Fee ,Type Cdde f o r the service you are appvlng ,for. Fee Type Codes may be found In FCC

i:ee Fillng Guldes. Enter.In C o l m n (8) the Fee Multiple, If, applicable. Enter h C o l m (C) the result
obtahed from rnultlplyhg
by the number entered In Colunn:(B), If any.

lhe value o f the Fee Type Code In Colvnn

'(a

FEE TYPE COD$

..- ...

i1,
r-sE C T I 0 N

I
I I .

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To be used onb .when you ,are requesting c o n c w e n t actions whlch result. In a

ADD ALL AMOUNTS SHOWN IN COLUMN C, LINES
MROUGH (61, AND ENTER THE TOTAL HERE.
THIS AMOUNT SHOULD EOUAL YOUR ENCLOSE0
REMITTANCE.
'

ID
TOTAL AMOWT REMITTED

I

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' ~ D E R A L COMMLlNlCATlONS COMMISSION
'vu'ashlngton, DC 206154

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APPROVED BY OM0

3080-0065

APPLICATION FOR NEW OR MODIFIED RADIO STATION AU'THORIZATION UNDER PART 6
OF FCC RULES
EXPERIMENTAL RADIO SERVICE (OTHER THAN BROADCAST)

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AppliQant'~Name and Post Of flce address
(Street addrclty, state, and ZIP Code. See instruction
Na 4)

t!3.

[I

D

~ e w
statlon

Modlflcallon of exktlng authalreflon

Flle No:
Call Slgn:
~ppllcatlonfor Modlflcation: Check the box beslde all partlculara to be modified. Check either addltlon or replacement to lndlcate whether the change Is an addltlon or a replacement o f parameters In the current authorization

E:
,

%b). For Modlfloatlon Indloate below:

AppllfXtlOn for (check only one box)

1

DO NOT WRITE IN THIS BLOCK

Mle Na

FREQUENCY

17 addition or

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EMISSION

OTHER PARTICULARS

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-

D addltlon u

replacement?

additlon a replacement?

POWER
replacement?

-

addition

13LOCATION
u

replacement?

addklon

,

0escrlbe below a h attached EXHIBIT No.

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u

0 riplacement?

)

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Particulars of Operation (see Instruction below)
frcyency Irlr(s

POWER

m hclher kHz or MHd
-"

----

(A)

0

(C)

EMISSION

(Q

(0)

MmULATlffi
SIGNAL
IF)

NECESSARY WQWIDTH
(Wl)

M

--------

--.--

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--

List eaoh frequenoy or f requenoy b n d separately. (If more space Is requlW attach as EXHIBIT Na
Insert maxlmum RE output power at the transmitter terminals Speolfy units
1
(C:)
Insert maxlmum effective radlated power from the antenna (If pulsed emlsslon, speolfy peak power). Speclfy
unlts.
(11) Insert "MEAN" or "PEAK" (See deflnltlons In Part
(€3 Llgt each type of emlssion separately for eaoh frequenoy. (See Sectlon 2201 of FCC Rules)
(F3 Insert as appmprlate for the type of modulation:

(1) the maxlmum speed of keying In
bauda:
(2) maxlmum audlo modulatlng
fmquenoy;
(8) frequency devlatlon of
carrier:
(4) pulse duratlon and
repetition raw
For oomplex emlsslon~desorlbe in detall in the spaoe provlded below.

FCC Form 4 4 2
Page 2
(::I Descrlbe how the n e k s a r y bandwldth was
determlned In space provlded below.
March 1896
(I$
(E3

a.

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if ;3.

proposed location of transmltter and transmlttlng antenna (check only one box to lndlcate type of operation):
PIXEDIBASE
MOBILE
BASB AND MOBILE

lij,). If permanently located at a PIXED location, glve below:
Clty or Town
County
:Slate
bTlmber an:

Mc). If

moblle, describe the exact area of
operation

Btreet (or other lndio~lonof looation)

-j:i,)(l). Enter geogaphical coadiantes exact to the nearest second (see i~tructlon 10)
Lo-th Latitude (M-MM-SS)

West Longitude @XI-MM-SS)
0

0

5:d). Datum (see instruction 10):

--

. .. .. ...... .......

E. Is a dlreotional antenna (other than radar) used?

If " Y E S : give the followlng lnrormation:
(a) Width of beam in degree= at the half-power point
(b) Orlentatlon In horizontal plane

Mc)(lxnter georaphlcal coudlnates of the approximate
center of moblle operatlon (see lmtuctlon 10.)
N a t h Latltude
West Longitude
,
' I .
0
0
"

NAD 27

NAD 8B

YES

NO

(01 Orientation in vertlcal plane

7. Is thls authorlzatlon to be used for fulfilling the requirement of a government contract wlth an agency of the

Unlted State6 Government?
YES
I7 NO
If 'YES", attach as EXHIBIT No. -,anarrative
statement
-desorlblng
,
the government proJeot,
agenoy and contact number.
E.

Is this authorlzatlon to be used for the eXclUSlVf3purpose of developlng radlo equlpment for export to be employed
by stations under the Jurlsdictlon of a forelgn government?

YES
NO
the followlng lnformatlon: Provlde the oontract number and the
If "YES",attach @a
EXHIBIT No.
name of the forelgn government concerned.

6:

Is t h b authorlzatlon to be used for provldlng communlcatlons essential to a research proJect? (The radlo communlcation 1s not the obJeotlve of the research proJect
YES
NO
If "YES: attach as EXHIBIT No. ,
,
,
,
anarratlve
,
statement provdlng the followlng Information:
(a) A descrlptlon of the nature of the researah proJeot heirlg oonduated.
(b] A showing that the communlcatlons faollltles requested are necessary for the researoh proJect involved,,
(0) A showing that exlstlng communloatlons facilities are Inadequate.

ti

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g

13. If all the answers to Items 7, 8, and 9, ere

"NO ,attach as EXHIBIT No:--,

a narrative statement descrlblng
In detail the followlng:
(a) The oomplete program of research and experlmentatlon proposed 'lncludlng descrlptlon of equlpment'
and theory of operatlon
(b) The apeclfic obJectlves sought to be aaoompllshed.
(c) How the program of experlmentatlon has a reasonable promlse of oontrlbutlon to the development, extension,
'
expansion, or utlllzatlon of the radio art, or 1s along line not already lnvestlgated
lb'a). Glve an estlmate of the length of tlme that will be requlred to complete the program of experimentation proposed
--,
--,
-,
---,
---,
-,
In this applioatlon:,
(b) ~f less than 2 years, glve the length or tlme In months that the authorlzatlon requested In thls appllcatlon
wlll be required:
Would a Commlsslon grant of thls appllcatlon come wlthln Sectlon 1.1307 of the FCC Rules, such that It =have
a
12.
slgnlfloant environmental Impact (fir33 lnstruotlon Ill?
YES
NO
If "YES", attach as EXHIBIT No. ,-,----,an
Environmental Assessment as required by Seotlon L1311.

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0

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1E.

~ 1 s below
t

transmitting equlpment to be installed (If experimental. so state):

MODEL NUMBER

MANUFACTURER

."

NO. OF UNITS

FCC Form 4 4 2 - Page 3
March 1996

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I s the equlpment llsted In Item 1[3 capable of station ldentlflcatlon pursuant to Seotlon b1627

q

YES

NO

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I.

Wlll the antenna extend more than 6 meters above the ground, or If mounted on a n exlstlng bullding. wlll It extend
more than 6 meters above the bulldlng, or wlll the proposed antenna be mounted on an exlstlng structure other
than a bulldlng?'
.
YES
NO
If "YES,gkve the followlng (see instruation 9):
(a) Overall height above ground to tlp of antenna Is ,--meters.

--(b) Elevation of ground at antenna
site above mean sea level
1s
metera
(c) Dlslance to nearest alrcraft landlng area
Is ----,-,,--kllometem
,
,
(dl List any natural formations of exlstlng man-made structures
(hllls, trees, water tanks, towers, etcJ whlch, In
the opinlon of the appllcant, would tend to shleld the antenna from aircraft and thereby mlnlmlze the
aeronautloal hazard of the antenna
- , - - - , - ,

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13.

'

avertlcal
proflle
-sketch
-,
of total structure lncludlng supporting bullding.
(el Submlt as EXHIBIT No. -,I f any,glvlng helghts In meters above ground for all algnlficant featUrtm Clearly lndlcate exietlng portion,
notlng partloulars of avlatlon obstruction lighting already avallable.
Appllcant 1s:

5

(Check o n l y one boat

INDIVIDUAL

ASSOCIATION

PARTNERSHIP

CORPORATION

OTHER (desorlbe In space provided below)

q

I 7.

Is appllcant a forelgn government or a representative of a forelgn government?

IS.

Has appllcant or any party to this application had any FCC station lloense or permlt revoked or had a n y
appllcatlon for permit, Ilcense or renewal denled by thls Commlaslon?
OYES U N O
If YES,attaoh as EXHIBIT N a --a,
statement glving call slgn of llcense or permlt
revoked and relate olrcumstances.

--

...
15.

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YES

NO

n YES

Will appllcant be owner and operator of the statlon?

0

NO

::o. Glve name, tllle, and telephone number (lnolude area

code), and Internet e-mall address (If applloable) of person
who can best handle inqulrles pertaining to thls appllcatlon

.I .

APPLICANT ANTI-DRUQ

ABUSE CERTFICATION:

By cheaklng "YES: the lndlvldual applicant certifies that he or she 1s ellglble for thls llcense. Thls requires that
he or she ls not subjeot to a denial of federal benef1t.q lnoludlng FCC beneflts, as a result of a drug offense
mnvictlon pursuant to Sectlon 64501 of the Antl- Drug Abuse Aot of 1888, 21 USC. @8Z A non- lndlvldual applicant.
0.g. corporation, partnershlp or other unincorporated assooiatlon, certlfles that no party to the appllcatlon Is
subJeot to a denlal Of federal beneflts, pursuant to that seotlon. For deflnitlon of a "party" for these purposes,
see 47 CFR m02(b).
...
O Y E S
ON0
Llst below all exhlblts In numerloal sequenoe and the item number of form requlrlng the exhiblt ldentlfled.
:

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EXHIBII NUMBER

II~M NO. OF FORM

EXHIBI~ NUVIBER

ITEM NO. OF FORM

EXHIBIT NUMBER

ITEM NO. OF FORM

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I
FCC Form 4 4 2

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Page 4,
March 1996

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23

CERTIFICATION:

Attentlon: Read thls eertlficatlon carefully before
slgnlng thlr appllcatlon.
THE APPLICANT CERTIFIES THAT:

(a) Copies of FCC Rule Parts 2 and 5.are on hand; and
(b) Adequate flnanolal appropriations have been made to carry on the program of experlmentatlon which will
be conduoted by quallfled personnel: and
(c) All operatlons wlll be on an experlmental basls In accordance wlth Part B and other applicable rules, and will
be oonducted in suoh a manner and at such a tlme as to preolude harmful lnterferenoe to a n y authorized
Btatlon; and
(d) Grant of the authorization requested hereln wlll not be construed as a findlng on the part of the Commission:
(1) that the frequencies and other technlcal parameters speolfied In the authorlzatlon are t h e best
sulted for the proposed program of experlmentatlon, and

(2)that the applicant will be authorlzed to operate on a n y basls

other than experlmental, and
(3) that the Commlsslon is obligated by the results of the experlmental program to make provlslon In Its rules
fncluding its table of frequenoy allocations for applicant's type of opePation on a regularly llcensed basls.
APPLICANT CERTIFIES FURTHER THAT:
(e) ~ l the
l statements in the application and attached exhlblts are true, complete and correct to the best of the
applicant's knowledge; and

( f ) The applloant is wllllng to finance and conduct the experlmental program wlth full knowledge and

understanding of the above Ilmltatlons: and

(g) The applicant walves a n y clalm
to the use of a n y particular frequenoy or of the electromagnetlc spectrum as
against the regulatory power of the USA.

Slgned and dated this

day of

,I9

Name of Applicant
Imust cottespand p i t h name given on page I )

Title
Check appropriate classlflcatlon:

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Individual applicant

Member of appllcant partnership

~uthorlzedemployee

Offlce of appllcant corporation or association

\+ILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Tltla
,ii3 Section l O O l ) , AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Tltle 47,
!;sctlon 312(aHl), AND/OR FORFEITURE (U.S. Code, Title 47, Sectlon 603).

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NOTlFICATION TO INDIVIDUALS UNDER PRIVACY ACT OF 1874
AND THE PAPERWORK REDUCTION ACT OF 1980
I r~formatlonrequested through thls form Is authorized by the Communlostlons Act of 1934; a s amended, and specifled
I)y Sectlon 808 therein. The information wlll be used by Federal Communlcatlons CommIsslon staff to determine
~::.lglbllItyfor Issuing authorlzatlons In the use of the frequenoy spectrum and to effect the provlslons of regulatory
~~~lsponsiblllties
rendered by the Commlsslon by the Act. Informatlon requested by this form wlll be available to the
ly~blicunless otherwise requested pursuant to 47 CFR 0.4W of the FCC Rules and Regulatlons. Your response is required
!o obtaln t h b authorlzatlon.

I'l~blic repcrtlng burden for this collection of Information Is eslhated to average four (4) hours per response, Including the t h e
,'or revlewlng Instructions, searching existing data sources, gathering and malntalnlng the data needed, and completing and review.ng the collectlon o f informatlon, Send comments regardlng thls burden esttnate or any other aspect o f this collection of
informatlon, including suggestions for reduclng the burden to the Federal Comunlcatlons Commission, Records Management
Il.anch, Paperwork Reductfon Project (3060-00651,Washington, DC 20564. DO NOT send completed appllcatlons to this
~lcidress. Indklduals are not required to respond to thls collectlon unless It dlspiays a currently valid OMB control nmber.

"HE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OF 1974, P L 93-67Q. DECEMBER 31. 1974,
6 US.C. ~'&(e)(a,
.4NDTHE PAPERWORK REDUCTION ACT OF 1980, P
L 06-611, DECEMBER 11, ISSO, 44

US.C. 0507.

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Page 5
March 1896

FCC Form 4 4 2

~ C A T I U N S
CCIMMZSSION

Washington,

DC 20554
23-TSTRUCTIONS FOR CObELEPl3IG FCC N

R M 442

iBE'PLICATICYN FOR NEW OR M 3 D I F m W X O STATION AVPHORIZATION UNDER PART 5 OF
FCC RULES
I I E P E R RADXO
~
SEXVICE: (OTHER

THAN BROADCAST)

-

,l?lese instructims should be removed frm the fonn before the fom is mailed to the
~:?manissicm.

Gemera1 Ihformatlon and Znstructions:
:1.
Before this

applicatian is prepared, the applicant should refer to P
a r t s 0, 1, 2, 5,
and 17 of the Rules and Re ations of the Cdssian. Copies o f these rule parts, 47
CFR Parts
0 through 19
??valme) , may be purchased from the Superintendent of
Docwnents, Government Printing Office (GPO), Washington, DC 20402. You may telephone

the GPO Order Desk at
(202) 512-1800 for current prices.

APPLICATION FILIN(; PROCEDURES

~pplicantsare required t o submit one payment by check, bank draft or money order with

each application. Page

1 of the FCC Form

442 must show the correct fee type code and

remittance. Check, bank draft or money order must be made payable to the Federal
Codcatians Cotrunission, and be d r a m upon a United States f m c i a l institution.

Foreign, postdated, altered, or third-part checks are not acceptable.

D3 not send
cash.
Completed a licatiom should be

&tted
to the appropriate address

listed
below. For amount
fee, applicant should refer to the

OET F'EE FILING GUIDE.

3

a.

BYMAI~,:

FEDCOMMONICATIONS COMMISSION

Ezcpexiental Radio Service

P.O. BOX 350320

Pittsburgh, Pa 15251-5320

b. HAND-DELIVERY OR mIER

SERVICE:

F'EDER.ALI m ' I C A T I a S m S S T a

c/o Mellon Bank

Three Mellon Bank Center

526 William Penn Way

27th Floor, Room 153-2713

Pittsburgh, Pa 15259-0001

Attention: Wholesale Lockbox Shift Supervisor

*""f:licatians hand delivered or sent by courier s W d be placed in an

inner earelope
wit address ltall
and

then submitted to address llbll.
c.

Applications
&t ace classified (CQNFIDENTW OR

for National Security purposes must

be filed as follow: Submit page
1 of
FCC Form
442, showin the a ropriate fee code, payment and a letter
explaining that this is a c?aesifie%)a lication to address

Iranabove; suhit
the remaining

applicatim
to the fo 10wi.m~ address:
CLWSIFIED APPLICAT1CNS:

SECWZ?)

1

FEDERAL CKPMUNICATI~S-1SSION

Security Operatiom Staff, OMSD

Rom 411

1919 M Street, N.W.
Washingtan, D.C. 20554

FCC Form

442 Instmctians - Page 1
March 1996

1111 previous editions

of t h i s fonn are obsoleter

FEE TYPE CY)DE(s):

Fee Type Code:

Type of Application:
a. New station authorization

EAE
b. Modification ,ofauthorization

EN3
c. *Confidentiality

request

EN3

*Cmfidentialit Request: Applications filed with a request for the C ~ s s i o nto

withhold an iJormation fran public inspection, pwsuant to FCC rule prwvisions in 47

Code.EAB. These applications ttut also

CFR 0.457 (67, shall use

the additional Fee

contain a letter justifying the withholding of information in accordance with 47 CFR
0.459 of the Rules.

~f a corporaticm,

state corporate name; if a partnership, state names of all partners
and the name under which the
partnership does business; if an unincorporated

association, state the name of an executive officer( the office held by him, and the

name of the associatian. If
this application 1nmlves a station that is now

authorized, the name shown must

correspond exactly

with that nam shown on the

current

authorization.

applicatim. Failure to do so

Applicants should make every effort to file c lete

may result in a rejection and return of the app ication or a delay

in the processing

of the application.

=T

Each document required to be filed as an exhibit ehould be
current as of the date of

filing I£ a current and complete answer to any estion other than questions 1, 2 and

3 , is already on file wi+n
the

Cdssion, ;fen the question may be answered by

reference to such information on file.

.

To refer to the material on file it is necessary that the applicant provide

sufficient

information to locate the previously filed material. If filed with a station

a plicaticm, furnish name of a plicant or licensee, call sign, file n-r,
and date

the matters in

of filing. In other
cases gurnieh date of
fils.,and descr*
ccmnection with which filed.

Each document or statement required to be filed as an exhibit should be

ndered
separately. Exhibit numbers should be shown in the blank space provided for this

e in the individual items of the application form.

Where the space left in the

!?Eation for narrative answers is insufficient e se-te
statement, bearing an

&$&bit nrnnber in s ence with other exhibits nunibered m the a licaticm, should be

attached to the apPxtian

and reference to the statementla&it
nunber should be
made in the answer space.
When the antenna structures pro sled to be erected will extend more than 6 meters above
ground or abuve an exieting Kilding the applicant
-t
analyze the
structu.
pursuan! to Part 17, Subpart B I of the k X 2 rules, to determine if notification to FAA

1s required. If notification is required, the ap licant should submit I344

Form 7460-1,

FA7l Regional

Officea
(Notice of Pmposed Ccnstructim or Alteraticnf to one of the

lieted on FCC Form 854, (R est for Antenna Height Clearance and Obstruction Marking

and Lighting

Specificati-y.

The latitude and longitude for locations in the United States and the Caribbean Islands

trust be referenced to either the North American Datum of 1927
(NP9 27) or 1983
(NAD
83). Topographical maps indicate which datum was used. Coordinates (latitude and
longitude) should be accurate to within +/- 5 rn of the National Spacial Reference

System.

If the proposed facility m a have a si ificant erdrmental impact, as defined in

section 1.1307 of

the KC &st

the apP'T"icantmust suhnit an environmental

assessment
as

reqyired by Section 1.1311.

FCC

Form 442 Inskmctions - Page 2
March 1996