Form FCC 5610 FCC 5610 Application to Participate in Rural Broadband Experiment

Application to Participate in Rural Broadband Experiments and Post-Selection Review of Rural Broadband Experiment Winning Bidders.

WCB_XXXX_Form 5610 Screenshots_080814

Application to Participate in Rural Broadband Experiments - Government

OMB: 3060-1200

Document [pdf]
Download: pdf | pdf
FCC

Auction System

Applicant/Bidder Access

Lo In InIUrrnStIon
The Applicant/Bidder Access section is password protected. Please type your FCC Reistratiori
Number {FRN) and its associated password to access th Auction Application or Bidding
ey tern An FRN/passwcrd is not repuired for th Public Access section of the sy ten,

Password

______________

-

____________

Forgot your Paaswordt'
FRN hotlinS informgtjoji

Need en FRN?
Register with the FCC
Not aure f you have an FRN?
Search the FCC Registration Svatem database to determine if vixi have been asgioned en

FCC

Loqted In: INN 00049794t11 (Lou CoLt)

My Auctions Page

Spectrum! Broadcast
FiFe new or modify an existing auction short-form application
Clrck here to file FCC form '5

Mobility Fund
File new or modify an existing auction short-für-no applicatioii
Chh Fort IC file FCC FCrm 20
File new or modify an existing auction long-form application
Cliok here to file_f CC FQ'm 620

Rural Broadband Experiments
File new or modify arm existing applicótion to participate in the rural broadbaijd experiments
çlrrk htre t tnt FCC Form 5510
File mrtm On noodiFy OxistirlO pool-selectIon review materials
Cic. I ro I: file FCC Fr nro

Online Bidding (Mock Auction)
There are no MOCK auctions available.

Online Bidding (Live Auction)
There are no UVF auctions available.

Auctions

______

> Wirales > Auctions > Auction Applcation

Approved by 0MB (FCC Form 5610)
3060-1166 (Notice to Aoolicants)

Auction Application Manager
Create or Review Applications

Approved by 0MB (FCC Form 5620)
3060-1.168 (Notice to Aoolicants)

Create a New Form 5610 Application

No new auctions
Review or Modify Existing Form 5610 Applications

96
Final Phase Closed

Charles Barkley

Withdrawn

11/15/2013, 5:38 PM

901

FCC Test

Withdrawn

8/10/2012, 3:22 PM

FCC Test Corporation

Not Submitted

5/27/2014, 9:13 AM

FCC Test
Long Form Filing Window Closed A12j2014, 6:00 PN

Not Submitted

11/22/2013, 2:07 PM

FCC Test Corporation
Q2
Long Frii, FLung ,'indw Closed 7,'2201.., 600 M

Not Submitted

5/27/2014, 9:13 AM

Final Phase Closed
902
Final Phase Closed

Create a New Form 5620 Application
No new auctions
Review or ModiFy Existing Form 5620 ApplIcations

• Edit Application

8/10/2012, 5:22 PM

v
_U]ed tr.

Asct,er, Apphcation

FF15 001 376uF1.

Auction 199

Apphcant: wert

initia' FiIiig CIosns 08/31/2014 6:00 PM (Er)
Status. Subutitled
Your changes have been saved but lOT
SUBeITTED. in ode for yscr chançns to Lake
eFient yea mu Cm*ify &Sebm6 yor appilnalien.

WCB - Rural Broadband Experiments

Applicant Information
Applicant information denttfis the applicant, its responsible parties (where applicable), its auction contact patty, and its bidding eligibility. Contact individual wiH be sent correspondence
concerning application. The applicant name will be used as the bidder name during the auction.
Applicant Legal CIaesW.cs,tion
To determine the applicant information required by the FCC please provide your Legal Classification.
Consortium

l Summary

&i Attachments

Pant Preview

Steps
Applicant Information
Agreements
Ownership
Summary
Certify & Submit

Corporation
0
l

general Partnership
Government Entity
Individual
Limited Liability Company
Limited Liability Partnership

l

Limited Partnership

t

Trust

What is the deference
between a warning and an
error'
What if my Leaal
ClaSsification is not listed?

Unincorporated Association
Oescriyticr, o LnoI Ciussficittcr,
•

Comniori Questions
When is my data savod
dunno the data entry
Drocess'

Other

Applicant St6tu5 (not required)
What is your status? Cfieclt all that apply
1 Minority Owned Business
Rural Telephone Company
I Woman Owned Business

What doeS th Quit link do?
if'7u76u
Test Question 2 added by
Test Question 3 by Ramva

Liriizi

AMSSiOn

A.tho

pp.tnn

LDeQed In: FRN 301376U84 Ug..it

Applicant: wrrt

Auction 199

nital Filing Closes: 08/35/2014 GrOG PM (ET)
St5tu: Submitted
Your changer b'ue been sared but NOT
SUBMITTED. In oda, for your changer to tako
efyact. you moot C.rtiy & Srbrnit your alicor.

WCB - Rural Broadband Experiments

Surnniar

Applicant Information

Steps
Appticnt Information

Applicant Name

AQreenlents
Please provide the following irtormation. The name entered wert will be used as the Bidder Name dunnQ the auction
Sntity Name:

wert

Ownership
Summary

)urisdict ion of Formation;

^dabama

Certify & Submit

ApplicarstAddre.ss (O

•:.:

rnII-:d:

Cbd here IF address is Iocted o,:tcde Lh US.

Address Line 1;

wart

Address Line 2:
City:

SrI

State:

District of Colurn0l

Zip Code:

22222

> L

iftLrs >

> boction Apglicatien

Ic: FItN (JCI': :i

Applicart wert
Initial Filing Conns: P8/35/2014 6:00 P11 LET)
Status: 5ubmltted

Auction 199
-

filtJmrnard

WCB - Rural Broadband Experiments

Applicant Information

Your changes haoe been crud but NOT
SLISMETTED. En order fr yow cravgr to tlue
ou mcet Certfy 5. 8bn.ib ysir applicøbari.

ahrnents

Print Preview
Steps
Applicent Inlormation

Responsible Prtv - Other

A0reements

Ideritify sri individual as the responsible pgrty for ttie entity

Ownership

FirI
mmm

Name:

Mi

Last

_______-

Stiffdc

Summary
Certify & Submit

TiLlS D cthSrelatiorizhip to Applicant
Title:

Common Questions
to
Telephone Number

222

Email Address:
Respon5ibIe Party fuIdros5
Click bore t dck: I; c A

Address Line 3:

332 -

3232

When is my data saved
durino the dtd entry
_________________

111

mmm.DbtigmsiI.corn
---.

..... .

rotted)

uLccl? tb Lit.

DO I have to fill in the
Telsohone Number 2nd Email
Address for our responsible
Wh ig considered to be a
Resoonsibte Patty7

wet

AddFesy Line 2:
City:

art

State:

DisluidotColtimbia

Zip Code:

22222

Test Ouestion 2 added by
-

Lciei

FT.I JC

Applieant: wart

'Iirc

Initial FiIiSg Ctsunv: 0f31f2014 6:00 PM (ET)

Auction 199

= Status: Submitted
Your changes have been saved but NOT
SUBMITTED. Is order for your chanacu to La ho
effeot yconmant Cectify & Sebasit yar appIiroLiar

WCB - Rural Broadband Experiments

Summary

Applicant Information

Attachments

Print Preview

X

Steps
Applicent Intornietion

Contact Information

Agreements
Contact udividual wmll be sent correspondence concerning applicat!on.

... t

Mi

Name:

tester

tester

Ownership
Summary
Certify & Submit

Area
Telephone Number: 202

222

- 2222

Common Questions

Area
202

222

- 2223

When is my data saved
during the data entry
process?

Fax Number:

Em.

Email Address:

What ix th difference

Contact Address (PG Boxes am-a not permitted)

between a warning and an
error?
Whot is the contort

Click here if nddress is located outside the US.

Address Line 1:

200 12th S1rgt

-

Address Line 2:
City:
State

Zip Code

Washington
I Bistro

22102

I Cumbla - -

intonnation used for?
Our official contact would
rotiher communicate via
phort orfas. Do I need to
enter their email address?
Why are P.O. boxes not
perrmijttedt
Test Ouestion 2 added b
Rdffl

> Auutien

f> Sill! >
LI ln Fj

1t34

ppIFcatIorr

_QukJ

• Ayplicant; wert
Initisi Fume Cotes: O8f31/0i4 5:00 PM (El)
Status Submitted

Auction 199

Your changes lava bean saved but NOT
SUBMITTEO. Cv order for yo..n vharrgee to take
etiect, ou nru.b C.rify & Subrnft your application.

WCB - Rural Broadband Experiments

1JI!1iIIOf

Applicant Information

A

chnjrit.s

Prin Prvmw
Steps

Authorized Bidders

Applicant Information
AQreements

ldenbfy at least one but rio more than three authorized bidders. Only individuals listed here will be authorized to bid on behalf of the applicant. The authorized bidders may be chanced duriri
the auction.

Ownership

First
1. IssIer

Mt
I

Last
tester

2.

All

811

3.

cli

1l

-_______

Suli,x

Summary
Certify & Submit

= Auntion Aopiic.bon
LJG L;

Appont: wnrt
nitiai Filinç CIoes: 0a/31fa014 0:00 PM (El)
Status: Submitted

Auction 199

'loui chngee have been sayS bijt NOT
SUBMTED. In order v yoorrhnngen rv

oftest, yos must Certify &SobmiL yolir application.

WCB - Rural Broadband Experiments

Summary

r Attptihrnnt

Print Preview

Agreements
Applicant Inrormation

Agreements with Other PCrties and Joint Bk
Has the applicant entered into partner-ships,
any such aqreernents retsting to the post-au
dyes
No

ventures, rancor-Ha or other agreements, acrangernents or understandings of any kind relating to the licenses being auctioned, including
market structure?

Agreements
Ownership
Sursrmary
Certify & Submit

Common Quesfiouls
When is my data saved
dunna th data entry
orocess

What is the difference
between a war-nina and en
What is the sgeofic rule
governing agreements.
arrdngeryients, and tlip like?
Test Ouestton 2 added by
Rdmva

FIG
F-RN OO

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Aypl,conG weil
LnitiI iri

Auction 199

C!useu 08/31/2014 600 PM (ET)

SttI.I1 Submitted
Your dionges have lieen i0vnd btit NOT
Iii IM [flED [n vidni br y.o.r vhrigei to take
vffect uu w tC ify&5bwit your ppIicatuon.

WCB - Rural Broadband Experiments

E$ummar

Attachments

Print Proview

Agreements
View/Edit Agreements

Applicant Information
Agreements

Agreements with Other PartIes and )oint Bidding Arrangements

-

-

Edt -

OwnershEp

Ye5

Summary

Certify & Submit
You currently have I agreement
Common Que5tious
When is my data saved
during the data enttv
process?
What is the difference
between a warning andgn
iCONTNUE

:

Test Ouestion 2 added by

arn

Auction Apphctir

Ec 'ii
L1zI i: E.N cC57c: ke_Q1'

AppIicant xyi corp
nitial Filing Closes: 011131/2014 O110 P11 (ET)
Stgton Submitted

Auction 199
WCB - Rural Oroadband Experiments

Summary

Agrecment5

chments

Print Preview
steps
Applicant Information

Edit Agreement Identifier

Areemerits

Açrepment Identifier
Agreement identifier:

A

-

Agreement I

- ----

--

-

---------------------------

Ownership
-

Summary
Certify & Submit
çVtw,lT

Common Questions
When iS my deta saved
during the data entry
procgss?

What is the difference
a warnirso anan
error?

Test question 2a1d

by

lictlaii

ft

Pt

Lani> Aoction AppIitIor,

Applicanh xyl corp

Stt7 .Qit:

Initia Filinç Closes: 08/31/2014 6U0 PM (El)

Auction 199

StaSis: Submitted

WCB - Rural Broadband Experiments

rrt

Agreements
Add Parties

! AttCmrlts

Print Previes

Steps

to this Agreement

Applicant Informhon
agreements
Ownershp
Sursrnary
Certify & Submit

Add Perties

Add up te three parbes belew, You may add mare parbes later.

Party To Agreenient
SelePt either Entity OR Individual:
Entity

Entit)'

What is the dfererice
between a tvarnina and an
eor?

Individual

Name:

Test.Quspii2 added by

FRN:
Fit

Individual

Ml

Lt

Name:
'RN:

__________

5eprch FRN)
___________________ ___________

___________ ______

C_______

Pdrty To Agreement
Select either Entity OR Individual:

Entity

Individual

Name:
FRN:

ISeardi FRN
Fjrt

Individual

Mt

lilt

Name:

FRN:

Sitcb,.EBN

___________________________________ ______________________

________

Party To Agreement
Select either Entity OR Individual:
Name:
Entily

Entity

FRN:

Individual

(Searth FRN)
hIT

CI

tEiii

' Auction Appilition
Applicant: xyz corp

Logged n: FRN QUO5792C? (gg_Q(

initl Filurti CIoes: 08/3112014 6:00 PM (El)

Auction 199

Status: 5ubmltted

WCB - Rural Broadband Experiments

Summary i Attachments

Print Preview

Q(.

Agreements
Applicant information

Create New Agreement

Agreements
Identify all parties with whom Applicant has entered into partnerships, joint ventures, consortia or other agreements, arrangements or understandings of any kind relating to the licenses
being auctioned, including any such agreements relating to the post-auction market structure,
Provide an identiflying name for your agreement.
Agreement Identifier:

Agreomant2

Ownership
Summary
Certify & Submit
Common Questions
When is my data saved
during the data entry

Add Pertley
Add up to three parties below. You may add more parties later.

What is the difference
b e tw een a warn4no and an
error?

Party To Agreement

Do I have to provide an FCC
Registration Number (FRN) for
mY agreement party?

Select either Efltity OR individual:
Name:
Entity

Individual

Entity

What does the Search FRN

FRN:

(Search FRN)
Ml

Individual

Name:

Test Ouestion 2 added by

&ot

Ix

-

FRN:

-

--

(Search FRN)
*51T)

_______

Party To Agreement
Select either Entity OR individual:
Name:
Entity

Individual

Entity

FRN:

(Search FRN)
First

individual

MI

Suff:c

t,at

Name:
FRN:

(Search FRN)

Party To Agreement
Select either Entity OR Individual:
- ..

Entity

-

Individual

EQ
-I

S Audion AppLktion

It77'v. (Loo_tit)

I Applicant: Wert
Iruiti& Filir Closnt: 05/31/2014 6flQ PM (ET)
Status: Subnittted

Auction 199

V,nr rhr ue hove bnonoed hot NOT
SUBMITTED I order (or you.ur
rujes to Umke
st(ct, you nsot CmEify & S.baot ycor u yplicaSon

WCB Rural Broadband Experiments

Summary

Ownership

Attachrnnts

Print Preview
Steps
pplicanL Erdoiniition

View/Edit Ownership Disclosure information

Agreements
Applicant Summary

Ownership

Add Dtsclosable Interest Holder to AppIicrit

Sunmtar
Certify & Submit

Add FCC Retiulatd business to Anolicant

ConUfloil Queetionc

Vuc-u- ill FCC tevuulatyd Biutitesles of the Aoplicnt

When is my data saved
during the data entry
nrocess7

Disciosable Interest Holders of this Applicant

You currentLy have specified

DiscioSable Interest Holder(s)

What is the difference
bOtween a warning and ami
error?

Disciosable Interest Holder Iiid-3 n4-3

csrrertIy hevs spesilied 0 FCC Regsoted Ousinoes eId by thus Dudosable Inteest tiolder

-

What is a controlling
interest of an agDlicant?

-

Test Question 2 added by

ppIkation
• Applicant xyz corp

L1:IFJ

Initial Filing CEoes: O8/51/O14 6OO PM (€1)

Auction 199

Status: Submitted

Your changes have been sound but NOT
SUBMITTED. In order fur your rhange to take
off net, you nsost CntiEy &Subnsit your application.

WCfl - Rurel Uroadband Experiments

Summary

&i Attachments

ê Print Preview

X

Steps

Ownership

AppIicnt Information

Add Disciosable Interest Holder

AQreem cots
Disciosable Interest Holder Name and Type
Select either Entity OR Individual:
Entity

Entity

Name:

ownership
..-

- Individual

Summary
Certify & Submit

-- - -

Common Questions
0th

When is my data saved
dunnp the data entry
process?

-

Type
FRN:

(Search FRNI

What is the difference
between a warning and an
First

Individudl

Name:
FRN:

_________

MI

Loot

sup,

.
.

What sq Disthaabie
Interest Holder (DIH)?

(Search FRN)

Is the FRN reguired7

_________

_________

__

__

Test Question 2 added by
Ramva

Auction Applicitign

tti2fl
Ir

I-t U(J

(1

2.i:I

Applicoct: xyz corp
Initial FiLing Clsse: OBf3/2Qi4 6:00 PM lET)
Status: Submitted

Auction 199

Your chin9., hay. b..n saved but NOT
SUflMITT5L. En order ror your changes to t,ke
.fF.ct you must C.rtffy&Subnntt your .ppilcathnn.

WCB - Rural Broadband Experiments

iSsjwmarv

Attachnents

Ownership

Print Presiew

Qt

Steps
Applicant Information

Add FCC Regulated Dusiness to Applicant

Agreements
FCC Rewilated_Business
Identify OntitiCs ni which th

i

______________________________
Applicant hag an interest. You ma' Se1eL titicre,Irtrady ubmltted or begin entering the information below.

FCC Reulatgd Business

--

Prindpgl Bu51ne55

1
-.

---

FRN

Ownership
Summary

1T

Percent of Interest Held
byApplicent

Certifti & submit
Common QUesliOns

____________-j

When is my data saved
doTing tb data entrY
Drocess?
What is the difference
between a warning and an
What does the Search FRN
link do

Whet is en FCC Reoulated
BusingSs (FRB)P
Is the FRN required?
What does Percent of
Interest l-leld refer to?
Must an indirect ownmershio
interest percentage be
included in Pencentgf
Interest Held?
IiQfl2dStk!

-

° &5111 ° 8c.tmzis u Suebon Appli.ttgn

!r: FRN
IrtjtioF Filing Closes: 08/3i/014 6:00 PM (ET)
StatSS: 5uhmItLd

Auction 199

YoUr thaziges have boon uaved but NOT
SUBMITTED. Lu or4ur For your chaue to tko
ofleut, you mueCertsFyS.jbnrIk your pp ctioe

WCB - Rural Broadband Experiments

St)rnn)ary

Attachments

ApU:cant Information
Agreements

Type:

Description:
An ettechmeot riiay not be

CIruv*To .u'pucayio,.)

PnnLPreyew

Steps

Add lrttechment

File:

t! Attachments

Ownership
fements

id Information
Descriptive Dais

-

Summary

1

Certify & Submit

greater than Formal Ptopssal
Indirect Owitership
WSivur

________________

Other

(AnAc)
___________
Dracess?
What is the difference
between a warnina and en

Indirect Ownership

7/2212014. 2:26 PM

Spectrum Access

test WCE

7/23/2014W 12:05 PM

Agreements

Oidder Agreement

8/1/2014, 1:26 PM

Descriptive Data

QQ

8/1/2014 1:26 PM

Bid Iniorreatian
Forriiot Proposal

8/1/2014, 1:26 PM
Formol ProosI

8/1/2014, 1:27 PM

Remove -

Whet attachnients are
reouired?
Wht ore the Tyoe' of
Attachments?
Ouestinri for oaues wh rip
section

Test Ouestiori 2 added by

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Lggd Lt ERN OO13761

Auction AIktion

(LQ_I

Apphcant: wert
nitjaI Filiciç C1cs: 0B/31/2Q24 6:00 PM (ET)
SOtu! Submitted

Auction 199

Voor choge hive bQtn
bot NOT
SUBMITTED. to ofoyoc chnN. to tk.
fft yo.. n .tCmtify &5.bn,it your
pIirtI0rr.

WCB - Rural Broadband Experiments

Summary

Attachments

Attachrnrtty

PrIrfLsm
Steps

Applicant information

View/ Edit Attachments

AQreements
Att6chments
You currently have 6 attachments

X^^j.ü

______________

Cc)

Ownership
Summary
Certify & Submit

EcC

WirsIujs

uctor SppFication

LvcI 1r FrJ G•: h1

Applicant: wert
initial Filing Closec: 08/3112014 6:00 PM (El)
Status: Submitted

Auction 199

Your changes have been saved but NOT
sUBMrrrED t coder nr y srnhar,ges to take
.efteot. nov nsat Certify & Submit your araslivation.

WCB - Rural Broadband Experiments

Attachrnegts

Summary

Print Preview

QIJIL

Steps
Applicant Information

Summary OvervIew
-

Choose a step listed belOw to review your provided inrormation.

-.----

--

Agreements

--

Ownership

Applicant Information

Cvi)

Agreements

C Y.iit)

Ownership

C________

Attachments

C:VYcT

Summary
Certify & Submit
Coninlon Que5tions
What i l certtfv arid any of
the certifications are falso?
When is my data saved
during the data entry
orocess7

Once you are confident that the application is ready for certificatipri 3nd submission, click on the Continue To Certifr button below.
_______________________
(cONTINUE TO CERTIFY )

What is the dfferance
between a warning and an
error?
What does thecheck Errors
buondo'
Test OIestion Zadded by
TEt123 alsrt(1234)


°

!ti11i

0 5ctios A5plicetiun

Logged Im FRN OO137&

pp1cant: wert
Initil Film3 Closes: 08/31/2014 6r00 PM (CT)
Status; Submitted

Auction 199

Your changes have been saved but NOT
susMirrED. In ordu fe your hanguv to ruke
you must C,rtify Suirnuit your appl,cat;orr.

WCB Rural Broadband Experiments

Summars

Print Preview
Print AppIictlon
Pnnt the data you have added to the Auction Application by selecting from the list below.
Click 'Continue' to open a prtritable riage.
Li Applicant information
U Agreements
LI Ownership
LI Certify & Submit
ID Attachment List

Attachenenta

Pr:nt Prtview

Steps
Print Attachrnent5
Click on a link below to open a PDF to print.
indirect Ownership - indirect Ownershj
Spectrum Access - test WCB
Agreements - Bidder Agreement
Descriptive Data DO
Bid Information Formal Proposal - [ornial PrspDsal

Applicant Information
Agreements
Ownership
Summary
Certify & Submit
Common Qne5tions
Test question 2 added by

PIJ LI I t
a

a

Auction Appiictio.u

iuaOtJll

pSOflt XucO C0'p

IuiitiI FiIin Closes: OB/31f20i4 5:00 P11 (CT)
StatuS: Submitted

Auction 199

You chuno b,v5 bvod bs NOT
SUBMITTED. I,, order Io you, Au ruOu to loIo
yea nuunt CnrEify Submit your ppeutior,

WCB

-

Rural Broadband Expedments

5ummary

Certify & Submit

Print Preview

Attachments

Steps
Applicant lnforrriatiori

Certify Auction Application

Agreements

Py clickIng th "Submit" button below, I certify the following:

Ownership

.
.
(1) This application drsclose5 all real patties in interest to any agreements involving
the applicant's participation in the competitive bidding.

Summary
Certify & Submit

(2) The Applicant, each party capable of controlling the Applicant, and each party that may be controlled by the Applicant or by a party capable of controlling the Applicant have complied with

and will Continue to comply with Section 121002 of TitLe 47 of the Code Of Federal ftegulations.

Consnson Questions

(J) The Applicant is financially and technically capable of providing seriice in each area for which it seeks support.

When is my data saved
during the data entry
Or000ss?

(4) The Applicant has available funds for all project costs that exceed the amount to be received from the Rural Broadband Experiments,
(5) The Applicant will offer service ri supported areas at rates that are within a reasonable range of rates for similar service plans Offered by voice and broadband providers iii urban areas,
(6) The Applicant either (a) has been designated as an Eligible Telecommunicaboris Carrier pursuant to Section 214(e) of TitLe 47 of the United States Code (47 USC 214(e)) in areas for which

it will seek support OR (b) will obtain designation as an [ligible Telecorrimijnications Carrier pursuant to Section 214(e) of Title 47 of the United States Code (47 USC 214(e)) in areas for which
it will seek support,
(7) If the Applicant's proposal includes the use of spectrum access, the description of this spectrum access in areas for which the Applicant will seek support provided in this application to
participate in competitive bidding is correct.
(8) The Applicant and any party to this application are not subject to a denial of federal benefits pursuant to Section 5301 of the Anti-Drug Abuse Act of 1'BB.
(9) The Applicant shall tenet the threshold requirements for each category of bid that the Applicant submits.
.

an
error'
-

Is it necessary to read all of
these crtifiçations
Who is authonzed to certify'
After I fill out my application
lctronically, is it
automatically subjoitteti to
the FCC?

By clicking the 'Subunit' button below, I, the individual identified as the Applicants certifying representative below, declare under penalties of perjury that, based on all the information
available to the Applicant, all the infomiatuon provided in or with this application, including the certification statements above, are true and correct.

After I submit nsy Form 175
once, are arty later changes
autOre4tica V tu m e 0

Siqnatiire

TeSt Question 2 added by

_______________
first
MI

Person Certifying:
Signature:

last
-

Title:

(IescK

hrst

Ilirerlor

)

List

- --

Suffix

)
I

) Auction

ppFii5or

ii.-:! II'•

Auction 199

AppIcar: xyz corp
TriI FlEng CIoses O6f31/O14 6O9 PM CCT)
Stetus: Submittea

WCB - Rural Broadband Experiments
Certify & Submit
Auction Applicatkrn Submit Confirmation
Your Auction Application has been received on 8/7/2014 at 1:00 PM. Your ulle number is 0002958007. Please iinL your applicaton for your records.

XQ
Steps
Applicant Information
Areernents
Ownership
Surnniary
Certify & Submit

When is my data saved
during the data entry
orocess?
What is the difference
between a wamino and ai
error?
What is Form 159 and how
du.If'll iLout?
How can I Get S coDy of the
information I submitted?
Must I do to the Uofront
Calculator and Form 159
immediatlv'

How will I know the status of
my Form 175?
When can I see the Form 175
jthgr soplicants for the
auction?

TestQjestion 2 added by


File Typeapplication/pdf
File Modified2014-08-08
File Created2014-08-08

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