Form FCC Form 2100 FCC Form 2100 FCC Form 2100, Application for Media Bureau Audio and Vi

Federal Communications Commission
Washington, D.C. 20554

Not Yet-Approved by OMB
3060-0027

INSTRUCTIONS FOR FCC FORM 2100
APPLICATION FOR MEDIA BUREAU
VIDEO SERVICE AUTHORIZATION
served by a grant of the request.

GENERAL INSTRUCTIONS
A.

We have estimated that each response to this collection of
information will take on average 3.5 hours for different
Schedules attached to this form. Our estimate includes the
time to read the instructions, look through existing
records, gather and maintain required data, and actually
complete and review the form or response. If you have
any comments on this estimate, or on how we can
improve the collection and reduce the burden it causes
you,
please write the Federal Communications
Commission, AMD-PERM, Washington, DC 20554,
Paperwork Reduction Project (3060-0798). We w i l l also
accept your comments via the Internet at [email protected].
Please do not send completed application forms to this
address.
You are not required to respond to a collection of
information sponsored by the Federal government, and
the g o v e r n m e n t ma y n o t conduct o r s p o n s o r this
collection unless it displays a currently valid OMB
control number with this notice.
This notice is required by the Privacy Act of 1974, Public
Law 93-579, December 31, 1974, 5 U.S.C. § 552a(e)(3)
and the Paperwork Reduction Act of 1995, Public Law
104-13, October 1, 1995, 44 U.S.C. 3507.

B. Purpose of Form. FCC Form 2100 is a multi-purpose
form. It is used to apply for authority to construct a new
commercial TV broadcast station, for a new or a
modification of an existing broadcast station license, and
to perform a variety of other miscellaneous transactions
in the M edia Bureau ( M B).
The purpose of this form is to collect data pertaining
to the proposed request. This data is used by the FCC
to determine whether the public interest would be

All previous editions obsolete.

C.

Introduction. FCC Form 2100 is a multi-part form
comprising a Main Form and several optional schedules.
Each application, amendment, modification, or other
request must contain only one Main Form but may
contain as few or as many of the optional schedules as
necessary.

D. Main Form. The Main Form contains questions and
certifications applicable to all FCC Form 2100 filers. The
Main Form is required for every application filed on
FCC Form 2100, including Modifications and
Amendments.
E. Schedules
The purposes of the optional schedules are as follows:
(1) Schedule A
The Schedule to apply for authority to construct a
new commercial TV broadcast station or to make
changes in the existing facilities of such a station. In
the case of new station and major modification
proposals, this Schedule is filed by either the
successful bidder at a broadcast frequency auction or
by an applicant proposing facilities that are not
mutually exclusive with any other application filed
during the same window and thus not subject to
the Commission's comparative bidding procedures.
All proposals for minor changes to authorized
commercial stations are also to be filed using this
Schedule.
Approved by OMB control number:
3060-0027.
(2) Schedule B
The Schedule for applying for a new or modified
noncommercial educational or commercial digital
television (DTV) broadcast license. The Schedule

FCC 2100 Instructions
September 2014

may be used to cover an authorized construction permit
(or auxiliary antenna), provided that the facilities have
been constructed in compliance with the provisions and
conditions specified on the construction permit and to
implement modifications to existing licenses as permitted
by 47 C.F.R. §§ 73.1675(c), 73.1690(e). Approved by
OMB control number: 3060-0837

INSTRUCTIONS
INFORMATION

Applicable Schedules Required for TV Broadcast
Stations
Service
Licensing Modernization
Form/Schedule Title
FCC 2100 Main Form – Application
for Media Bureau Audio and Video Service
Authorization Schedule A – Schedule for a
Construction Permit for a Commercial Broadcast
Station Approved by OMB: 3060-0027

TV
Broadcast
Stations

FCC 2100 Main Form – Application for Media
Bureau Audio and Video Service Authorization
Schedule B – Schedule for a Digital Television
Broadcast Station License Approved By OMB:
3060-0837

SECTION

I:

GENERAL

Upon grant of a license application, the Licensee may be
subject to certain construction or coverage requirements.
Failure to meet the construction or coverage requirements
may result in termination of the license. Consult
appropriate FCC regulations to determine the
construction or coverage requirements that apply to the
type of license requested in this application.

F. Schedules Required

TV
Broadcast
Stations

FOR

A. Electronic Filing
FCC Form 2100 must be filed electronically.
B. Exhibits
Each document required to be filed as an exhibit should
be current as of the date of filing. Each page of every
exhibit must be identified with the number or letter of
the exhibit, the number of the page of the exhibit, and
the total number of pages of the exhibit. If material is
to be incorporated by reference, see the instruction on
incorporation by reference. If interference studies are
required by rule, attach these as an exhibit.
C. Incorporation by Reference
You may incorporate by reference documents, exhibits,
or other lengthy showings already on file with the FCC
only if the information previously filed is more than
one 8½” by 11” page in length, and all information
therein is current and accurate in all significant respects;
the reference states specifically where the previously filed
information can be found (i.e., station call sign and
application file number, title of proceeding, docket
number and legal citations), including exhibit and
the
relevant item number
page references.
Use
followed by ‘A’. Items that call for numbers, or which
can be answered ‘Y’ or ‘N’ or other short answers
must be answered directly without reference to a
previous filing.

GENERAL FILING INSTRUCTIONS
A. Provide
All
Information
Requested:
Applicants should provide all information requested by the
application.
If any portion of an application is not
applicable, the applicant should so state.
Defective or
incomplete applications will be returned without
consideration.
Inadvertently accepted applications are
also subject to dismissal. See 47 C.F.R. § 73.3564(b).
B. Information Current and Complete:
Information filed with the FCC must be kept current
and complete. The Applicant must notify the FCC
regarding any substantial and significant changes in the
information furnished in the application(s). See 47
C.F.R. § 1.65.

D. Station Public Inspection File
A copy o f t h e c o m p l e t e d a p p l i c a t i o n and all
related documents shall be made available for inspection by
the public
in the station’s public inspection file pursuant to 47 C.F.R.
§73.3526 for commercial stations and 47 C.F.R.§
73.3527 for noncommercial educational stations.

C. Applicable Rules and Regulations:
Applicants should obtain the relevant parts of the FCC’s
rules in Title 47 of the Code of Federal Regulations. Copies
of Title 47 may be purchased from the Superintendent o f
Documents; Government Printing Office; Washington, DC
20402; (202) 512- 1800. Refer also to the Government
Printing Office’s website at http://www.access.gpo.gov.
Some FCC rules require the Applicant to attach one or more
exhibits to an application in addition t o the information
requested in the application form.

E. Certifying Compliance
This
application requires
applicants
to certify
compliance with many statutory and regulatory
requirements. Each response contained within the
application constitutes a certification. Furthermore, each
applicant is responsible for the information that the
application instructions and worksheets convey. As a key
element in the Commission's streamlined licensing process, a
certification that these materials have been
reviewed
and that each question response is based on the applicant's
review is required.

2

F.

Detailed instructions and worksheets provide additional
information regarding Commission rules and policies.
These materials are designed to track the standards and
criteria that the Commission applies to determine
compliance and to increase the reliability of applicant
certifications. They are not intended to be a substitute for
familiarity with the Communications Act and the
Commission's regulations, policies, and precedent. Each
applicant is responsible for the information that the
application instructions and worksheets convey. Applicants
are required to review all application instructions and
worksheets.

3201. Facility ID Number. Radio and TV Facility ID
Numbers can be obtained at the FCC's Internet Website at
www.fcc.gov/mb. Once at this website, scroll down and
select CDBS Public Access. You can also obtain your
Facility ID Number by calling: Radio (202) 418-2700, TV
(202) 418-1600. Further, the Facility ID Number is now
included on all Radio and TV authorizations and postcards.
For Assistance
For assistance with this application, contact the
Federal Communications Commission, 1270 Fairfield
Road, Gettysburg, PA 17325-7245, call (877) 4803201 (TTY 717-338-2824), or visit
http://esupport.fcc.gov.

G. 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 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.
Thus, a "No"
response to any of the certification items will not cause the
immediate dismissal of the application provided that an
appropriate exhibit is submitted.

INSTRUCTIONS FOR FCC 2100 MAIN FORM
A. Fees, Waivers, and Exemptions
The Commission is statutorily required to collect charges for
certain
regulatory
services
to
the
public.
Applications requiring a fee, as well as the corresponding
fee, are listed in the "Media Bureau Fee Filing Guide,"
which can be found on t he C o m m i s s i o n ’ s website,
www.fcc.gov.
Government entities, ho wever, are
e x e mp t fro m this f e e
requirement. Exempt entities
include possessions, states, cities, counties, towns,
villages,
municipal
organizations,
and
political organizations o r s u b p a r t s thereof governed
by elected o r appointed officials exercising sovereign
direction
over communities or governmental programs.
Also exempt are full- service noncommercial educational
radio and TV broadcast l i c e n s e e s a n d p e r m i t t e e s ,
provide d
t h a t the pro p osed facility will be
operated noncommercially. See
47 C.F.R. § 1.1116.

H. Authorization to Sign the Application
The applicant and the applicant's authorized representative,
if any, must sign the application. Depending on the nature
of the applicant, the application should be signed as
follows: if a sole proprietorship, personally; if a partnership,
by a general partner; if a corporation, by an officer; for an
unincorporated association, by a member who is an officer;
if a governmental entity, by such duly elected or appointed
official as is competent under the laws of the particular
jurisdiction. Counsel may sign the application for his or
her client, but only in cases of the applicant's disability or
absence from the United States.
See 47 C.F.R.
§ 73.3513.
The signature of an electronically filed
application consist of the electronic equivalent of the typed
name of the individual. See Report and Order in MM
Docket No. 98-43, 13 FCC Rcd 23056, 23064 (1998).
I.

When filing a fee-exempt application, an applicant must
indicate the reason for the fee exemption and provide an
explanation as appropriate.
Applicants have the option of paying by credit card or
by FCC Form 159 when submitting the application.
For further information regarding the applicability of a fee,
the amount of the fee, or the payment of the fee; applicants
should consult the "Media Bureau Fee Filing Guide,"
which can be found on Commission’s website,
www.fcc.gov.

FCC Registration Number (FRN)
To comply with the Debt Collection Improvement Act of
1996, the applicant must enter its FRN number, a ten-digit
unique entity identifier for anyone doing business with the
Commission. The FRN can be obtained through the FCC
webpage at http://www.fcc.gov or by manually submitting
FCC Form 160. FCC Form 160 is available for
downloading from http://www.fcc.gov/formpage. html or
by calling 1-800-418-3676. Questions concerning the FCC
Registration Number can be directed to the Commission’s
Registration
System
help
desk
at
http://[email protected] or by calling 1-877-480-

B. Applicant Information
Applicant Name, Type, and Contact Information: The
name of the applicant must be stated exactly. If the
applicant is a corporation, the exact corporate name; if a
partnership, the name under which the partnership does
business; if an unincorporated association, the name of an
executive officer, his/her office, and the name of the

3

partnership interest.

association; and, if an individual applicant, the person's
full legal name.

Applicants must also comply with the separate alien equity
ownership benchmark restrictions of Section 310.
Under the second prong of the analysis, an applicant must
determine the pro rata equity holdings of any alien investor
in a licensee entity or its parent.
In calculating alien
ownership, the same voting interest multiplier rules apply.

Applicants should use only those state abbreviations
approved by the U.S. Postal Service.
C. Contact Representatives. If the applicant is represented
by a third party (for example, legal counsel), that person's
name, firm or company, mailing address and
telephone/electronic mail address must be specified.

In order to complete this two-prong analysis, an
applicant must determine the citizenship of each entity
holding either a voting or equity interest or explain how it
determined the relevant percentages. Corporate applicants
and licensees whose stock is publicly traded have
employed a variety of practices, including sample surveys
using a recognized statistical methodology, a separate
restrictive class of stock for alien owners, and the
compiling of citizenship information on each stockholder
by the corporation's stock transfer agent, to ensure the
accuracy and completeness of their citizenship disclosures
and their continuing compliance with Section 310.

D. Alien Ownership. All applications must comply with
Section 310 of the Communications Act, as amended.
Specifically, Section 310 proscribes the ho ld ing a nd
transfer o f a broadcast construction permit or station
license to an alien, a representative of an alien, a foreign
government or the representative thereof, or a corporation
organized under the laws of a foreign government. This
proscription also applies with respect to any entity of which
more than 20% of the capital stock is owned or voted by
aliens, their representatives, a foreign government or its
representative, or an entity organized under the laws of a
foreign country. The Commission may also deny a
broadcast construction permit or station license to a licensee
directly or indirectly controlled by another entity of which
more than 25% of the capital stock is owned or voted by
aliens, their representatives, a foreign government or its
representative, or another entity organized under the laws of
a foreign country.

Finally, Applicants are directed to review the policies
and clarifications set forth in Commission Policies
and Procedures Under Section 310(b)(4) of the
Communications Act, Foreign Investment in Broadcast
Licensees, Declaratory Ruling, MB Docket No. 13-50,
28 FCC Rcd. 16244 (2013).

Compliance with section 310 is determined by means of a
two-prong analysis, one pertaining to voting interests and
the second to ownership interests. See, e.g., BBC License
Subsidiary L.P., 10 FCC Rcd 10968 (1995). The voting
interests held by aliens in a licensee through intervening
domestically organized entities are determined in
accordance with the multiplier guidelines for calculating
indirect ownership interests in an applicant as set forth in
the "Corporate Applicant" Instructions . For example, if
an alien held a 30% voting interest in Corporation A
which, in turn, held a non- controlling 40 % voting
interest in Licensee Corporation B, the alien interest in
Licensee Corporation B would be calculated by
multiplying the alien's interest in Corporation A by that
entity's voting interest in Licensee Corporation B. The
resulting voting interest (30% x 40% = 12%) would not
exceed the 25% statutory benchmark. However, if
Corporation A held a controlling 60% voting interest in
Corporation B, the multiplier would not be utilized and
the full 30 percent alien voting interest in Corporation A
would be treated as a 30 % interest in Licensee
Corporation B, i.e., an impermissible 30% indirect alien
voting interest in the licensee. If Partnership A held a
40% voting interest in Licensee Corporation B, that
voting interest would be similarly impermissible if any
general partner or any non- insulated limited partner of
partnership A was an alien, regardless of his or her

E.

4

Parties to the Application. This section requires the
disclosure of information on the applicant and all parties
to the application. As used in this application form, 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 relation to an applicant or
licensee, which will confer on its holder that degree of
influence or control over the applicant or licensee
sufficient to implicate the Commission's multiple
ownership rules. In responding, applicants should review
the Commission's multiple ownership attribution policies
and standards which are set forth in the Notes to 47
C.F.R. §73.3555, as revised pursuant to Report and Order
in MB Dockets 02- 277 and 03-130, and MM Dockets
01-235, 01-317, and 00- 244, 18 FCC Rcd 13620 (2003),
aff’d in part and remanded in part, Prometheus Radio
Project, et al. v. F.C.C., 373 F.3d 372 (3d Cir. 2004),
stay modified, No. 03-3388 (Sept. 3, 2004), and/or as
revised in Review of the Commission's Regulations
Governing Attribution of Broadcast and Cable/MDS
Interests, 14 FCC Rcd 12559 (1999), reconsideration
granted in part, 16 FCC Rcd 1097 (2000) 2006
Quadrennial Regulatory Review- Review of the
Commission’s Broadcast Ownership Rules and Other
Rules Adopted Pursuant to Section 202 of the
Telecommunications Act of 1996, Report and Order
and Order on Reconsideration, MB Docket No. 06-121 et

G. The Commission defines an “eligible entity” as any entity
that qualifies as a small business under the Small Business
Administration’s size standards for its industry grouping, as
set forth in 13C.F.R. §§ 121-201, and holds (1) 30 percent
or more of the stock or partnership interests and more
than 50 percent of the voting power of the corporation or
partnership that will own the media outlet; or (2) 15
percent or more of the stock or partnership interests and
more than 50 percent of the voting power of the
corporation or partnership that will own the media outlet,
provided that no other person or entity owns or controls
more than 25 percent of the outstanding stock or
partnership interests; or (3) more than 50 percent of the
voting power of the corporation that will own the media
outlet if such corporation is a publicly traded company.
In the event the Applicant claims status as an eligible
entity, the Applicant must submit an explanatory exhibit
d e m o n s t r a t i n g c o m p l i a n c e . The A p p l i c a n t
m u s t retain and provide on request, material
documentation, including, for example, annual financial
statements or tax returns, etc., used to establish the basis
for the applicant’s response.

al., 23 FCC Rcd 2010 (2008) (“2006 Quadrennial
Media Ownership Order”).
Generally, insulated limited partners or members of a
limited liability corporation, certain investors, and certain
creditors are not considered parties to the application.
However, as set forth in Worksheet #2E entitled, "Investor
Insulation and Non-Party Influence over Applicant," the
holder of such an interest may be deemed a party to the
application and, if so, must be listed. In the event that the
Investor Insulation and Non- Party Influence over
Applicant worksheet requires the submission of an
explanatory exhibit, the applicant must respond "No" to the
Equity and Financial Interest certification located in the
Attributable Interest Section of the application and
complete this exhibit.
F. Equity/Debt Plus Attribution Standard.
Certain
interests held by substantial investors in, or creditors of, the
applicant may also be attributable and the investor
reportable as a party to the application, if the interest falls
within the Commission's equity/debt plus (EDP) attribution
standard. Under the EDP standard, the interest held is
attributable if, aggregating both equity and debt, it exceeds
33 percent 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 or crossownership rules – AND the interest holder also holds (1) an
attributable interest in a media outlet in the same market, or
(2) supplies over 15 percent of the total weekly broadcast
programming hours of the station in which the interest is
held. For example, the equity interest of an insulated limited
partner in limited partnership applicant would normally not
be considered attributable, but, under the EDP standard, that
interest would be attributable if the limited partner’s interest
exceeded 33 percent of the applicant’s total asset value
AND the limited partner also held a 5 percent voting interest
in a radio or television station licensee in the same market.

H. Additionally, "parties to the application" includes the
following with respect to each of the listed applicant
entities:
Individual Applicant: The natural person seeking to
hold in his or her own right the authorization specified in
this application.
Partnership Applicant: Each partner, including all
limited partners. However, a limited partner in a limited
partnership is not considered a party to the application IF
the limited partner is not materially involved, directly or
indirectly, in the management or operation of the media
related activities of the partnership and the applicant so
certifies in response to the Equity and Financial Interest
certification. Sufficient insulation of a limited partner for
purposes of this certification would be assured if the
limited partnership arrangement:

The interest holder may, however, exceed the 33 percent
threshold without triggering attribution where such
investment would enable an eligible entity to acquire a
broadcast station provided that: (1) the combined equity and
debt of the interest holder in the eligible entity is less than
50 percent, or (2) the total debt of the interest holder in the
eligible entity does not exceed 80 percent of the asset value
of the station being acquired by the eligible entity and the
interest holder does not hold any equity interest, option, or
promise to acquire an equity interest in the eligible entity or
any related entity. See In re Promoting Diversification of
Ownership in the Broadcasting Services, Report and Order
and Third Further Notice of Proposed Rule Making, 23 FCC
Rcd 5922 (Mar. 5, 2008).

13

(1)

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;
(4)

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

(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 art 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.

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 in this context, 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 noninsulated, regardless of the partnership interest,
is considered a party to the application.

Notwithstanding conformance of the partnership agreement
to these criteria, however, the requisite certification cannot
be made IF the limited partner’s interest is attributable
under the Commission’s EDP attribution standard
described below; or 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.

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:

Limited Liability Applicant: 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 the Equity
and Financial Interests Certification.

(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.

And Other Applicant: Each executive officer, member
of the governing board and owner or holder of 5% or more
of the votes in the applicant is considered a party to the
applicant.

Corporate Applicant: Each officer, director and owner of
stock accounting for 5% or more of the issued and
outstanding voting stock of the applicant is considered a
party to the applicant. Where the 5% stock owner is itself a
corporation, each of its stockholders, directors and
"executive" officers (president, vice-president, secretary,

I.

14

Equity and Financial Interests. Applicants are directed
to review compliance with the Commission’s broadcast
attribution rules and policies, as discussed in the
instructions to the Parties to the Application Section.

J.

(1992).

Multiple Ownership. These items require that the
applicant either certify compliance with, or request waiver of,
the Commission's broadcast ownership rules, including
restrictions on investor insulation and participation of nonparty investors and creditors. An Exhibit is required only if
requesting a waiver demonstrating compliance with 47
C.F.R. § 73.3555(a) or, if the applicant cannot certify
compliance, requesting a waiver or exemption, with adequate
justification. In order to facilitate the evaluation of the
transaction that is the subject of FCC Form 2100, applicants
are directed to Worksheet #2, which is tailored to the
individual inquiries.

K. Eligible Entities: The Commission defines an “eligible
entity” as any entity that qualifies as a small business under
the Small Business Administration’s size standards for its
industry grouping, as set forth in 13 C.F.R. §§ 121- 201,
and holds (1) 30 percent or more of the stock or partnership
interests and more than 50 percent of the voting power of
the corporation or partnership that will own the media
outlet; or (2) 15 percent or more of the stock or partnership
interests and more than 50 percent of the voting power of
the corporation or partnership that will own the media
outlet, provided that no other person or entity owns or
controls more than 25 percent of the outstanding stock or
partnership interests; or (3) more than 50 percent of the
voting power of the corporation that will own the media
outlet if such corporation is a publicly traded company.
In the event the Applicant claims status as an eligible entity,
the Applicant must select "Yes" to the Multiple Ownership
Question and submit an explanatory exhibit demonstrating
compliance. The Applicant must retain and provide on
request, material documentation, including, for example,
annual financial statements or tax returns, etc., used to
establish the basis for the applicant's response.

B.

Channel and Facility Information and Antenna
Location and Technical Data. The applicant must ensure
that the facility specifications are accurate. Conflicting data
found elsewhere in the application will be disregarded. All
items must be completed. The response "on file" is not
acceptable. The response "not applicable" is not acceptable
unless otherwise noted.

C.

Notifications. All applicants must comply with the
requirements of Section 73.1030. Specifically, applicants
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. The Commission need not be
informed of the date of such notification.

D.

Antenna Structure Registration. For information when
an Antenna Structure Registration (“ASR”) number is
required and how to acquire an ASR number, please
review the information posted on the Commission’s
website at http://www.fcc.gov/category/help/wirelesstelecommunications-bureau/asr-overview.

E.

Transmitter Make and Model. An indication as to the
specific transmitter make and model is not required by
Schedule A. Rather, any permit authorizing construction
will require installation of a type- accepted transmitter or
one complying with the provisions of 47 C.F.R. Section
73.1660.

F.

Coordinates. Applicant should use NAD 83 for the
geographic coordinates of the transmitter site in their
applications.

CONSTRUCTION PERMIT CERTIFICATIONS

INSTRUCTIONS FOR SCHEDULE A - SCHEDULE FOR
CONSTRUCTION PERMIT FOR A COMMERCIAL
BROADCAST STATION

A . Environmental Effects. 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 and modifications
of existing stations must contain either an environmental
assessment that will serve as the basis for further
Commission review and action, or an indication that
operation of the station will not have a significant
environmental impact. See 47 C.F.R. §1.1307(b). In this
regard, applicants are required
to look at eight
environmental factors.
These factors are relatively selfexplanatory, except for the evaluation of whether the station
adequately protects the public and workers from potentially
harmful radiofrequency (RF) electromagnetic fields.
Worksheet #3 includes both a general environmental
evaluation and specific sub-sections for RF exposure
analysis.
These pages are designed to facilitate and
substantiate the Environmental Effects certification. Their

GENERAL APPLICATION INSTRUCTIONS
A. Financial Qualifications. Applicants are not required to
certify as to their financial qualifications in Schedule A.
See
Implementation of Section 309(j) of the
Communications Act -- Competitive Bidding for
Commercial Broadcast and Instructional Fixed Service
Licenses, 13 FCC Rcd 15920, 15989 (1998) ("Auctions
Order").
Nevertheless, the Commission's substantive
financial qualification requirements are unchanged.
All
applicants for new broadcast facilities must have reasonable
assurance of committed financing sufficient to construct
the proposed facility and operate it for three months
without revenue at the time they file Schedule A. See
Merrimack Valley Broadcasting, Inc., 82 FCC 2d 166,
167 (1980); Liberty Productions, 7 FCC Rcd 7581, 7584

15

use is voluntary, but strongly encouraged.
B.

Environmental Worksheet. Some, but not all, stations will
be able to use the RF worksheets.
Generally, the RF
worksheets can only be used in the following situations:
(1) single use tower; (2) single tower with several
FM/FM translators; or (3) a multiple tower AM array
with no other user co-located within the array.
Additionally, the RF worksheets can be used in regard to
an AM station only if access to the AM station is
restricted by a fence or other barrier that will preclude
casual or inadvertent access t o the site and warning
signs are posted at appropriate intervals describing the
potential for RF exposure.
See "RF Exposure
Compliance Worksheet Instructions" for more detail on
eligibility.

New RF Exposure Requirements. In 1996, the
Commission adopted new guidelines and procedures for
evaluating environmental effects of RF emissions. All
applications subject to environmental processing filed on
or after October 15, 1997 must demonstrate compliance
with the new requirements. These new guidelines
incorporate two tiers of exposure limits:
General population/uncontrolled exposure limits apply to
situations in which the general public may be exposed or in
which persons who are exposed as a consequence of their
employment may not be made fully aware of the potential
for exposure or cannot exercise control over their
exposure. Members of the general public are always
considered under this category when exposure is not
employment-related.

If after using the worksheets the applicant finds that levels
will exceed the RF guidelines, 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 or that describes measures
or
circumstances, which will prevent or discourage humans
from entering those areas where the RF exposureexceeds
the guidelines (e.g., fencing or remote location). The
guidelines are explained in more detail in OET Bulletin
65.

Occupational/controlled exposure limits apply to human
exposure to RF fields when persons are exposed as a
consequence of their employment and in which those
persons who are exposed have been made fully aware of
the potential for exposure and can exercise control over
their exposure. These limits also apply where exposure is of
a transient nature as a result of incidental passage through
a location where exposure levels may be above the general
populations/uncontrolled limits as long as the exposed
person has been made fully aware of the potential for
exposure and can exercise control over his or her exposure
by leaving the area or some other appropriate means.

If the applicant is not eligible to use the worksheets, it is not
an indication that the proposed facility will cause excessive
exposure. Generally, applicants that are not able to use the
worksheets will need to utilize more complex calculations
or measurements to demonstrate compliance.
For this
reason, a p p l i c a n t s w h o a r e n o t e l i g i b l e t o
u s e t h e worksheets should consider seeking the assistance
of a qualified consulting engineer in determining whether the
proposed facility will meet the RF exposure guidelines

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 97-01, 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://www/fcc.gov/oet/rfsafety.
Copies can also be
purchased from the Commission's duplicating/research
contractor, B C P I, 7 8 5 1 - E Bee c h r f t A v e n u e ,
Gait her s u r g , M D 2 0 8 7 9 (telephone: (301) 857- 3800;
fax: (202) 857-3805) or 445 12th Street SW, Rm CYC401, Washington, DC 20554. Additional information
may be obtained from the RF Safety Group at
[email protected] or ( 202) 4 1 8 -2464 o r from the FCC
Call Center at 1-888-CALL FCC (225-5322).

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:
(1) A description of the facilities as well as supporting
structures and appurtenances, and a d e s c r i p t i o n o f the
site as well as the surrounding area and uses. If highintensity white l i ghti ng is pr oposed 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.

The RF worksheets and tables appended to Worksheet 3
below will enable certain categories of stations to
determine whether or not the proposed facility will have
a significant environmental impact as defined by Section
1.1307.
All applicants can use the General

16

applications for new DTV stations, or requests to modify
the DTV Table that do not meet the minimum DTV–to–
land mobile spacing standards will, however, be
considered where all affected land mobile licensees
consent to the requested action. For the markets and
channels that Land mobile operations are authorized in see
47 C.F.R. §73.623(e).

(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.

D. Section 73.625: Community Coverage. The applicant
must certify that the proposed facility complies with the
Commission's community coverage requirements.
The
principal community contour is as follows for digital
television stations:

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

Channels 2-6:
Channels 7-13:
Channels 14-69:

BROADCAST FACILITY
A. Section 73.616: DTV Station Interference Protection.
The applicant must certify that the proposal will not cause
or increase interference to any other DTV broadcast
application, DTV allotment, or analog TV broadcast
authorization. Interference is to be predicted in accordance
with the procedure set forth in the Third DTV Periodic
Report and Order in MB Docket No. 07-91. See 47
C.F.R. § 73.616. If applicant cannot certify “Yes,” the
applicant must demonstrate that the proposal will not cause
or increase interference to any other DTV broadcast
application, DTV allotment, or analog TV broadcast
authorization.

To determine if the proposed facility complies
requirements of section 73.625(a) and (b), the
distance to the pertinent signal-strength contour
calculated using the standard methodology in 47
§73.625(b)
.

B. Section 73.622(i): DTV Table of Allotments. The
applicant must certify compliance with the digital television
channel allotment and operational requirements contained in
47 C.F.R. §73.622(i). Specifically, this question requires that
the applicant certify that the application specifies a channel
and community in accordance with the Commission's Table
of Television Allotments, 47 C.F.R. § 73.622(i), that it
will operate a facilities that does not expand the noiselimited service contour in any direction beyond that
established by Appendix B of the Seventh Report and
Order in MB Docket No. 87-268 establishing the new
DTV Table of Allotments in 47 C.F.R. § 73.622(i), and that
it will operate at post-transition facilities that match or
reduce by no more than five percent with respect to
predicted population from those defined in the new DTV
Table Appendix B.
C.

28 dBμ
36 dBμ
41 dBμ

Section 73.623(e): Protection of land mobile operations
on channels 14–20. The Commission will not accept
petitions to amend the DTV Table of Allotments,
applications for new DTV stations, or applications to
change the channel or location of authorized DTV stations
that would use channels 14–20 where the distance between
the DTV reference point as defined in 47 C.F.R.
§73.622(d), would be located less than 250 km from the
city center of a co-channel land mobile operation or 176
km from the city center of an adjacent channel land mobile
operation. Petitions to amend the DTV Table,

with the
predicted
must be
C.F.R.

E.

Section 73.1030: Notifications Concerning
Interference to
Radio
Astronomy,
Research,
and
Receiving Installations. All applicants must
comply with the requirements of section 73.1030.
Applicants 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.
The Commission
need not be informed of the date of such notification.

F.

Section 73.1125: Main Studio Location.
The
applicant must certify that its proposed main studio location
complies with the requirements of 47 C.F.R. Section
73.1125. In order to answer "Yes" to this q u e s t i o n , t
h e applicant's proposed main studio must be either (1)
within the principal community contour of any station
licensed to that community; or (2) within 25 miles from
the reference coordinates of the center of its community of
license. A community's reference coordinates are generally
the coordinates listed in the United States Department of
the Interior publication entitled Index to the National
Atlas of the United States. An alternative reference point,
if none is listed in the Atlas, is the coordinates of the
community's main Post Office.
In order to qualify as a "main studio," the proposed
location must be equipped with type-accepted equipment
and capable of originating programming at any time.
Additionally, the studio must be staffed by at least one
management-level employee and one staff-level employee
at all times during regular business hours. See Jones,
Eastern of the Outer Banks, Inc., 6 FCC Rcd 3615

17

(1991), clarified, 7 FCC Rcd 6800 (1992), aff'd 10 FCC
Rcd 3759 (1995). Additionally, each TV broadcast station
must at all times maintain a toll-free telephone line from its
community of license to its main studio, wherever located.

another pending application, or as required by 47 C.F.R.
§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. The applicant should also
fully explain why the adverse finding is not an impediment
to a grant of this application.

LEGAL CERTIFICATIONS
A. Character Issues and Adverse Findings. The Character
Issues Section requires the 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. An applicant must disclose
in the Adverse Finding Section 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 violates the Communications Act
or a Commission rule or policy and on certain specified nonFCC misconduct.
In responding to these Sections,
applicants should review the Commission's character
qualifications policies, which are fully set forth in Character
Qualifications, 102 FCC 2d 1179 (1985), reconsideration
denied, 1 FCC Rcd 421 (1986), as modified, 5 FCC Rcd
3252 (1990) and 7 FCC Rcd 6564 (1992).

B. Program Service Certification.
Applicants for
broadcast construction permits need no longer file a
specific program service proposal. Nevertheless, prior to
making the certification, the applicant should familiarize
itself with its obligation to provide programming
responsive to the needs and interests of
the residents of its community of license.
See
Programming Information in Broadcast Applications, 3
FCC Rcd 5467 (1988).
C.

Where the response to either Character issue question is
"Yes," 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
interest 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.

Local Public Notice.
(1) 47 C.F.R. § 73.3580 requires that applicants for
construction permits for new broadcast stations and
for major change in existing broadcast facilities (as
defined in 47 C.F.R. §73.3572(a)(1)) give local
notice in a newspaper of general circulation in the
community to which the station is licensed.
This
publication requirement also applies with respect to
major amendments as defined in 47 C.F.R.
§73.3772(b). Local notice is also required to be
broadcast over the station, if operating. However,
if the station is the only operating station in its
broadcast service licensed to
the community
involved, publication of the notice in a newspaper is
not required.
(2)

In responding to the Adverse Finding Section, 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 station 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 applicant may respond "No" to this item.
However, an adverse finding that has not been reported to
the Commission and considered in connection with a prior
application would require a "Yes" response.

Completion of publication may occur within 30
days before or after the tender of the application to
the Commission. Compliance or intent to comply
with the public notice requirements must be certified
by the applicant in Item 9 of Section II of this
application. The required content of the local notice is
described in Paragraph (f) of 47 C.F.R. § 73.3580.
Worksheet #1 attached to these instructions provides
additional guidance. Proof of publication need not
be filed with this application.

D. Auction Authorization. The Commission's Part
1 auction rules require all winning bidders for
construction permits or licenses to include certain
exhibits with their long-form applications. If this
application is being submitted to obtain a
construction permit for which the applicant was a
winning bidder in an auction, then the applicant must,
pursuant to 47 C.F.R. Section 73.5005(a), include an
exhibit containing the information required by the
following Part 1 auction rules, if applicable. (1) Section

Where the response to the Adverse Finding question is
"Yes," 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

18

1.2107(d) requires the applicant to provide a detailed
explanation of the terms, conditions, and parties involved
in any bidding consortium, joint venture, partnership, or
other agreement or arrangement it had entered into relating
to the competitive bidding process. See 47 C.F.R. Section
1.2107(d). (2) Section 1.2110(j) requires applicants
claiming designated entity status to describe how
they satisfy the requirements for eligibility for such status,
and to list and summarize all agreements that affect
designated entity status, such as partnership agreements,
shareholder agreements, management agreements, and any
other agreements, including oral agreements, which
establish that the designated entity will have both de facto
and de jure control of the entity. See 47 C.F.R. Section
1.2110(j). (3) Section 1.2112(a) requires that each longform application fully disclose the real party or parties in
interest and disclose specified ownership information,
including identifying any party holding a 10 percent or
greater interest in the applicant. See 47 C.F.R. Section
1.2112(a). (4) Section 1.2112(b) requires each
applicant claiming status as a "small business" to
disclose specified gross revenue information; to list and
summarize all agreements or instruments that support the
applicant's eligibility as a small business, including the
establishment of de facto and de jure control; and to list
and summarize any investor protection agreements. See
47 C.F.R. Section 1.2112(b).

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 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.
With respect to this question only, the term "party to the
application" includes if the applicant is an individual, that
individual; if the applicant is a corporation or unincorporated
association, all officers, directors, or persons holding 5
percent or more of the outstanding stock 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.
INSTRUCTIONS FOR SCHEDULE B –SCHEDULE
FOR
DIGITAL
TELEVISION
BROADCAST
STATION LICENSE
A.

E. Equal Employment Opportunity (EEO)
Applicants seeking authority to construct a new
commercial broadcast station are required to afford equal
employment opportunity to all qualified persons and to
refrain from discriminating in employment and related
benefits on the basis of race, color, religion, national
origin or sex. See 47 C.F.R. § 73.2080. Pursuant to
these requirements, an applicant who proposes to employ
five or more full-time employees in its station employment
unit must establish a program designed to assure equal
employment opportunity for women and minority groups
(that is, Blacks not of Hispanic origin, Asian or Pacific
Islanders, American Indians or Alaskan Natives, and
Hispanics). This program is submitted to the Commission
as the Model EEO Program on FCC Form 396-A, which
should be filed simultaneously with this application. If
an applicant proposes to employ less than five full-time
employees in its station employment unit, no EEO
program for women or minorities need be filed. General
guidelines for developing an Equal Employment
Opportunity program are set forth in FCC Form 396-A.

Channel and Facility Information and Antenna
Location and Technical Data. The applicant must ensure
that the facility specifications are accurate. Conflicting data
found elsewhere in the application will be disregarded.
All items must be completed.
The response "on
file" is not acceptable. The response "not applicable" is
not acceptable unless otherwise noted.

LICENSE APPLICATION CERTIFICATIONS
B.

Constructed Facility. The applicant must certify that
the facility was constructed as authorized in the
underlying construction permit. If there are any differences
between the facilities constructed compared with those
authorized in the construction permit, the applicant may
need to seek approval for the change on FCC Form 2100
Schedule A.

C. Special Operating Conditions: The special operating
conditions are located on the final pages of the
construction permit. Attach exhibits, if required, to
document compliance with the special operating
conditions.
NOTE: Special operating conditions may
prohibit automatic program test authority.

F. 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.§ 862.

D. Transmitter. A permittee or licensee installing as a main
transmitter one that is not included on the FCC’s “Radio
Equipment List, Equipment Acceptable for Licensing,”
must have first obtained authority to use such a
transmitter through the filing and grant of FCC Form

Section 5301 of the Anti-Drug Abuse Act of 1988

19

2100 Schedule A.

information will take from 3 to 6.25 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 e-mail them to [email protected] or send
them to the Federal Communications Commission, AMDPERM, Paperwork Reduction Project (3060-0027),
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 or if we fail to provide you with this
notice. This collection has been assigned an OMB control
number of 3060-0027.

CHANGING TRANSMITTER POWER OUTPUT.
Applicants proposing to replace an omnidirectional
antenna with another omnidirectional antenna or change
transmitter output power as a result of modifying the
transmission line system must check "Yes". NOTE: If
the applicant is proposing to replace an omnidirectional
antenna with another omnidirectional antenna, the new
antenna must be mounted not more than two meters
above nor four meters below the authorized values. See
47 C.F.R. Section 73.1690(c)(1). If the applicant is
proposing to change transmitter output power by
replacing its transmission line, the station's effective
radiated power must not change. See 47 C.F.R.
Section73.1690(c)(10). If the proposal meets these
requirements, program test operations may commence
at full power pursuant to Section 73.1620(a)(1).
A. Replacing a directional antenna.
This question is to be answered by applicants replacing a
directional antenna with another directional antenna. See 47
C.F.R Section 73.1690(c)(3). It requires the applicant to
certify and provide an exhibit demonstrating that: (1) the
proposed theoretical antenna pattern will not exceed the
licensed directional pattern at any azimuth and no change in
effective radiated power will result; and (2) the requested
modification of license complies with 47 C.F.R. Section
73.685(f).
NOTE: The new antenna must be mounted not more than
two meters above nor four meters below the authorized
values.

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

B. Use a formerly licensed main facility as an auxiliary
facility.
This question set forth a series of certifications for
applicants proposing the use of a formerly licensed main
facility as an auxiliary facility. This question requires the
applicant to certify and submit an exhibit showing that the
proposed auxiliary facilities will not extend beyond the
Grade B coverage area of the main antenna after the change
in ERP has been effectuated. See 47 C.F.R. Section
73.1675(a).
C. Change the license status.
Applicants may change their license status from commercial
to noncommercial or from noncommercial to commercial.
However, if changing from commercial to noncommercial
educational status, the applicant must submit as an exhibit a
completed Section II of FCC Form 340, establishing its
qualifications to operate the subject facility as a
noncommercial educational station. See 47
C.F.R. Section 73.1690(c)(9).
FCC NOTICE REQUIRED BY THE PAPERWORK
REDUCTION ACT
We have estimated that each response to this collection of

20

WORKSHEET #1

LOCAL NOTICE CHECKLIST
Applicants must certify that they have complied with Section 73.3580 regarding publication of local notice of the subject
application. This worksheet may be used in responding to Section II, Item 9 of FCC Form 301.
1.

Newspaper notice.
(a) Dates of publication:
(i) All within 30 days of tender of the application?

Yes

No

(b) Daily newspaper published in community?
(i) If yes, public notice must appear twice a week for two consecutive weeks.

Yes

No

(c) No such daily newspaper, weekly newspaper published in community?
(i) If yes, notice must appear once a week for three consecutive weeks.

Yes

No

(a) Once daily for 4 days in the second week following the filing of the application?

Yes

No

(b) At least 2 announcements during ''prime time'' (6 p.m. - 11 p.m. for television) or ''drive time''
(7 a.m. - 9 a.m. and/or 4 p.m. - 6 p.m. for radio), as applicable?

Yes

No

(a) Applicant name(s)

Yes

No

(b) Names of all officers, directors, 10% shareholders (if corporation), all non-insulated partners (if
partnership)

Yes

No

Yes

No

(d) Date on which application was filed

Yes

No

(e) Call letters and frequency/channel of station

Yes

No

(f) Statement that copy of application is available in Public File

Yes

No

(g) Location of public file

Yes

No

(h) Facilities sought: type and class of station

Yes

No

(i) Power sought

Yes

No

(j) Antenna height

Yes

No

(k) Transmitter site

Yes

No

(l) Location of studios

Yes

No

(d) If no such daily or weekly newspaper, local notice must appear in daily newspaper with the
greatest circulation in the community twice a week for two consecutive weeks.
2.

3.

Broadcast notice.

Text: do the announcements contain the following information?

(c) Purpose of application

For FCC Form 301 applicants only:

FCC 2100 Worksheet 1

WORKSHEET #2
This Worksheet may be used in connection with Section 11, Item 4 of FCC Form 301 regarding media ownership. For the convenience
of the applicant, the various ownership restrictions are treated under the following separate headings:
A. Multiple Ownership and Cross Ownership; B. Familial Relationships; C. Future Ownership Rights; D. Time Brokerage/Local
Marketing/Joint Sales Agreements; and E. Investor Insulation/Non-party Influence.
A. MULTIPLE OWNERSHIP AND CROSS OWNERSHIP
This section of the worksheet may be used in connection with Section II, Item 4 of FCC Form 301 to determine the applicant's
compliance with the Commission's multiple ownership rules and cross-ownership rules set forth in 47 C.F.R. § 73.3555. Radio
applicants: See also the Commission's Report and Order in MB Dockets 02-277 and 03-130 and MM Dockets 00-244, 01-235 and
01-317, 18 FCC Red 13620 (2003), aff d in part and remanded in part, Prometheus Radio Project, et al. v. F.C.C., 373 F.3d 372 (3d
Cir. 2004), stay modified, No. 03-3388 (Sept. 3, 2004) (''Report and Order''). The applicant must determine that it complies with all
applicable rules in order to respond ''YES'' to the certification in Item 4b.
NOTE: Such a certification of compliance does not exempt radio applicants from submitting an Exhibit that demonstrates such
compliance, including, if applicable, relevant contour maps.
I. LOCAL RADIO STATION OWNERSHIP
The local radio ownership rules place a numerical limit on the number of stations in which an entity in the local market may have
a cognizable interest. See 47 C.F.R. Sec. 73.3555(a). See also Report and Order, Section on ''Local Radio Ownership Rule.''
1.

Will grant of this application result in the applicant or any party to this application having a cognizable interest in more than
one commercial or noncommercial educational full-power radio station located in (i.e., having its community of license
within) or ''home'' to the same metropolitan area (Metro), as defined by Arbitron and reported by BIA? 1.

Yes

No

If ''Yes,'' provide in your Exhibit the name of the Arbitron Metro; proceed to Items 2 and 3, below. Use a separate worksheet for
each applicable Arbitron Metro (see supra note 1) and provide in the Exhibit the relevant information for all applicable Metros.
If ''No,'' the transaction does not involve stations in an Arbitron Metro; proceed to Item 4.
2. (a) How many commercial and noncommercial educational radio full-power stations are located within or are reported by BIA
as ''home'' to the Metro covered by this worksheet? 2.

The applicant must demonstrate compliance with the local radio ownership rule in each applicable Metro. Use a separate
worksheet for each Metro. Note that BIA may report a particular station as ''home'' to more than one Metro, including embedded or
overlapping Metros. Note also that a station may be reported by BIA as ''home'' to one Metro and have its community of license in a
separate Metro. Each such Metro is ''applicable.''
1.

Include all stations whose community of license is inside the boundaries of the counties that make up the Arbitron Metro. Also
include stations outside the counties that make up the Arbitron Metro if they are reported by BIA as ''home'' to that Metro. The BIA
Database generally includes all of the stations in a Metro. See also supra note 1.
2.

FCC 2100 Worksheet 2

(b) How many full-power commercial AM stations in the Metro will be attributable to the applicant or any party to this application
if the application is approved?

(c) How many full-power commercial FM stations in the Metro will be attributable to the applicant or any party to this application
if the application is approved?

(d) Total number of commercial stations in the Metro that will be attributable to the applicant or any party to this application if the
application is approved: 3.

If the applicant will own both commercial and noncommercial educational radio broadcast stations in the Metro, please also answer
questions 2(e) through 2(g) and include this information in the Exhibit:

(e) How many full-power noncommercial educational AM stations in the Metro will be attributable to the applicant or any party to
this application if the application is approved?

(f) How many full-power noncommercial educational FM stations in the Metro will be attributable to the applicant or any party to
this application if the application is approved?

(g) How many commercial and noncommercial educational full-power AM and FM stations in the Metro in total will be attributable
to the applicant or any party to this application if the application is approved? 4.

The following local radio ownership ''tiers'' have the stated limits on the number of stations in which a party (i.e., a person or single
entity or entities under common control) may have a cognizable interest in a Metro:
*

In a Metro reported by BIA as having 45 or more ''home'' commercial and noncommercial educational full-power stations,
a party may have a cognizable interest in up to 8 full-power commercial radio stations, not more than 5 of which are in the
same service (AM or FM);

*

In a Metro reported by BIA as having between 30 and 44 (inclusive) ''home'' commercial and noncommercial educational
full-power radio stations, a party may have a cognizable interest in up to 7 commercial full-power radio stations, not more
than 4 of which are in the same service (AM or FM);

*

in a Metro reported by BIA as having between 15 and 29 (inclusive) ''home'' commercial and noncommercial educational
full-power radio stations, a party may have a cognizable interest in up to 6 commercial full-power radio stations, not more
than 4 of which are in the same service (AM or FM);

3.

2(d) should equal 2(b) plus 2(c).

4.

2 (g) should equal 2(d) plus 2(e) plus 2(f).

FCC 2100 Worksheet 2 (Page 2)

*

In a Metro reported by BIA as having 14 or fewer ''home'' commercial and noncommercial full-power radio stations, a party
may have a cognizable interest in up to 5 commercial full-power radio stations, not more than 3 of which are in the same
service (AM or FM), except that a party may not have a cognizable interest in more than 50 percent of the total number of
full-power commercial and noncommercial stations in such a market; provided, however, that an attributable interest in one
AM/FM combination in the Metro is permissible without regard to this 50 percent limitation.

If the application complies with the limits set forth above, it complies with the local radio ownership portion of the multiple ownership
rules set forth in 47 C.F.R. Section 73.3555. As indicated above, all applicants must submit an Exhibit explaining their determination.
Be sure to include a copy of the Exhibit with the copy of the application that is sent to the station's public inspection file.
3. To demonstrate compliance with the numerical limits in the local radio ownership rule, applicants may not rely on a change in a
Metro's geographic boundaries that has occurred since September 3, 2004, unless such change has been in effect for at least two years.
in addition, applicants may not rely on the inclusion of a radio station as ''home'' to a Metro unless (a) such station was listed by BIA as
''home'' to the Metro as of September 3, 2004, or (b) such ''home'' designation has been in effect for at least two years, or (c) such
station's community of license is located within the Metro. Applicants also may not rely on the removal, after September 3, 2004, of
their own stations from BIA's list of ''home'' stations in a Metro unless (i) such exclusion has been in effect for at least two years or (ii)
the exclusion results from an FCC-approved change in the community of license of a station from within the Metro to outside the
Metro. Applicants who wish to rely on such changes should explain in their Exhibit, taking into account the timing conditions set forth
above in this paragraph, (1) any changes since September 3, 2004, to the geographic boundaries of the relevant Metros, (2) any
changes since September 3, 2004, to the ''home'' designations of the applicant's stations in the relevant Metros, (3) whether one or
more radio stations licensed to communities outside the Metro have been added to BIA's list of ''home'' stations for that Metro since
September 3, 2004; and (4) whether any of the changes reported in (1) through (3) of this paragraph is necessary for the proposed
transaction to comply with the local radio ownership rule.
4. Interim Contour-overlap Methodology. If any station subject to the application does not have its community of license located
within the geographic boundaries of any Arbitron Metro, then the following guidelines should be used to determine compliance with
the local radio ownership rule for any such station. These guidelines reflect the interim contour-overlap methodology (''Interim
Methodology'') that, for any station whose community of license is in a non-Metro area, is in effect until such time as the rulemaking
proceeding in MB Docket 03-130 is completed and new rules are established for such radio stations. See Report and Order, Section
VI.B., ''Local Radio Ownership Rule,'' 282-286, and Section IX, ''Notice of Proposed Rulemaking.'' If a station is listed by BIA as
''home'' to a Metro but the station's community of license is not within the geographic boundaries of that Metro or any other Metro, the
applicant must comply with the local radio ownership rule both under the Interim Methodology and under the Arbitron Metro
methodology.
Under the Interim Methodology, a radio market is defined as the area encompassed by the principal community contours (predicted or
measured 5 mV/m groundwave contour for AM; predicted 3.16 mV/m contour for FM) of the stations that are both mutually
overlapping and proposed to be ''commonly attributable'' post-transaction. The number of radio stations in this defined radio market
(i.e., the numerator) cannot exceed the limits set forth in Section 73.3555(a) (see below). A commonly attributable station whose
contour overlaps the contour of some but not all of the contours of the stations that define the radio market does not count toward the
local radio ownership limits (i.e., is not counted in the numerator). A graphic example is provided further below.

For purposes of this worksheet, ''commonly attributable'' means stations in which the applicant or any party to the application will
have a cognizable interest (see 47 C.F.R. § 73.3555, Notes) if the application is granted.
5.

As long as at least one of the commonly attributable radio stations has a community of license that is located outside a Metro,
applicants should count in the numerator every commonly attributable station that mutually overlaps such station(s),
regardless of whether the other commonly attributable stations are listed as being in Metros.
6.

FCC 2100 Worksheet 2 (Page 3)

Under this same Methodology, the number of stations in the market (i.e., the denominator) is determined by counting the full-power,
operating commercial and noncommercial educational stations whose principal community contours overlap or intersect at least one
of the principal community contours that define the radio market as described above, subject to the following exception: such a station
will be not be counted as being in the market (i.e., in the denominator) if (1) its transmitter is located more than 92 kin from the
perimeter of the area of mutual overlap of the commonly attributable stations that define the radio market, or (ii) the applicant or any
party to the application has a cognizable interest in the station and the station does not define the subject market (i.e., is not in the
numerator). Any radio station that meets this test should be included in the denominator, regardless of whether such station is in a
Metro. A graphic example is provided further below.
The following local radio ownership ''tiers'' have the stated limits on the number of stations in which a party (i.e., a person or single
entity or entities under common control) may have a cognizable interest in a non-Metro radio market:
*

In a radio market with 45 or more commercial and noncommercial educational full-power radio stations, a party may have
a cognizable interest in up to 8 commercial radio stations, not more than 5 of which are in the same service (AM or FM);

*

In a radio market with between 30 and 44 (inclusive) commercial and noncommercial educational full-power radio
stations, a party may have a cognizable interest in up to 7 commercial radio stations, not more than 4 of which are in the
same service (AM or FM);

*

In a radio market with between 15 and 29 (inclusive) commercial and noncommercial educational full-power radio
stations, a party may have a cognizable interest in up to 6 commercial radio stations, not more than 4 of which are in the
same service (AM or FM);

*

In a radio market with 14 or fewer commercial and noncommercial educational full-power radio stations, a party may have
a cognizable interest in up to 5 commercial radio stations, not more than 3 of which are in the same service (AM or FM),
except that a party may not have a cognizable interest in more than 50% of the total number of commercial and
noncommercial educational full-power stations in such market; provided, however, that an attributable interest in one
AM/FM combination in the Metro is permissible without regard to this 50% limitation.

If the application complies with the limits set forth above, it complies with the local radio ownership rule set forth in 47 C.F.R.
Section 73.3555(a). The applicant should mark ''Yes'' to Section 11, Item 4b of Form 301 and must submit an Exhibit providing
information regarding the market(s), broadcast station(s), and other information demonstrating compliance with 47 C.F.R. § 73-3555
(a).
If the application does not comply with 47 C.F.R. § 73.3555(a), the applicant should mark ''No'' to Section 11, Item 4b to Form 301
and must submit as an Exhibit a detailed explanation in support of a waiver of 47 C.F.R. § 73.3555 (a).
See the following page for an illustration of the Interim Methodology.

FCC 2100 Worksheet 2 (Page 4)

In the simplified example below, Stations AM1, AM2, FM1 and FM2 are proposed to be commonly attributable. Stations AM1,
AM2, and FM2 have mutually overlapping contours. They constitute a "radio market'' -- in this example, Market #1 -- for purposes
of the local radio ownership rules in a non-Metro area, and are thus counted against the local radio limit (i.e., in the numerator) in
Market # 1.
Because Station FM1's contour does not overlap the mutually overlapping contours of Stations AM1, AM2 and FM2, the proposed
acquisition of Station FM1 would not count as being in Market #1 and therefore would not be counted toward the local ownership
limit (i.e., in the numerator) for purposes of Market #1. Rather, in a non-Metro area, Stations FM1 and FM2 would need to be
analyzed as forming a separate ''radio market'' - in this example, Market 42. (Station FM2 would thus be counted as being in Market
#1 as well as in Market #2.)
Station FM3 is not commonly attributable and it would be counted as "in " Market #1 (i.e., in the denominator) because the
transmitter of Station FM3 is not more than 92 km from the perimeter of Market #1's mutual overlap area. Station FM1 would not
be counted as being ''in'' Market #1 (i.e., in the denominator) because it is commonly attributable to the proposed permittee.
Station AM3 in this example is not commonly attributable. It would, nonetheless, not be counted as being ''in'' Market #2 (i.e., in
the denominator) because its transmitter is located more than 92 km from the perimeter of Market #2's mutual overlap area. Stations
AM1 and AM2 also would not be counted as ''in'' Market #2 (i.e., in the denominator) because they are commonly attributable.

AM2

AM1

#1

FM2

#2

.
.
.

.
.
.

FM3 transmitter
49 km from
perimeter of
mutual overlap
area of Market #1

...

FM1

AM3 transmitter 95 km from
perimeter of mutual
overlap area of Market
#2

FCC 2100 Worksheet 2 (Page 5)

II. TELEVISION OWNERSHIP
This section of the worksheet may be used in connection with Section II, Item 4b for the proposed construction of a full-service
television station. The television ownership rules place a numerical limit on the number of stations that can be owned by one entity
in the local market and restrict the total national audience reach that can be attained by any one television station owner. See 47
C.F.R. Sections 73.3555(b), 73.3555(e), and Notes.
1.

Local Ownership. Will grant of this application for a commercial television station result in the
applicant or any party to this application having an attributable interest in another commercial
television station which is located within the same Designated Market Area (DAM) as measured by
Nielsen Media Research and whose Grade B contour overlaps the Grade B contour of the proposed
station?

Yes

No

Yes

No

Yes

No

Yes

No

If ''Yes'' to Question 1, at the time of filing of this application:
a. are both of the commercial television stations ranked among the top four stations in the DMA,

based on the most recent all-day (9:00 a.m.-midnight) audience share as determined by Nielsen
or a comparable professional survey organization?
b.

are there fewer than 8 independently-owned, operating, full-power commercial and
noncommercial television stations in the DMA?

If ''Yes'' to Question 1 a or b, the applicant must mark ''No'' to Section II, Item 4a and submit an
exhibit stating the reasons in support of an exemption from, or waiver of, the Commission's
television ownership regulations.
2.

National Audience Reach. Will the grant of this application for a commercial television station
result in the applicant or any party to this application having an attributable interest in commercial
television stations which have an aggregate national audience reach exceeding 35 percent?
If ''Yes'' to Question 2, the applicant must mark ''No'' to Section II, Item 4a and submit an exhibit
stating the reasons in support of an exemption from, or waiver of, the Commission's television
ownership regulations.

III. JOINT TELEVISION/RADIO OWNERSHIP
This section of the worksheet may be used in connection with Section II, Item 4b, when the applicant will have both full-service
television and full-service radio interests in the same local market, as defined by 47 C.F.R. Section 73.3555(c)(3).

1.

Will the grant of this application result in the applicant or any party to this application having or
maintaining an attributable interest in a commercial AM or FM station and a commercial television
station where:
a.

the 1 mV/m contour of the commercial FM station or the 2 mV/m contour of the commercial
AM station encompasses the entire community (communities) of license of the commercial
television station?

Yes

No

b.

the Grade A contour of the commercial television station encompasses the entire community
(communities) of license of the commercial AM or FM station?

Yes

No

If "Yes" to Question 1 a or b, proceed to Question 2.

FCC 2100 Worksheet 2 (Page 6)

2.

Will the applicant or any party to this application directly or indirectly own, operate or control more
than 2 commercial television and I commercial radio station, as a result of this transaction?

Yes

No

would the applicant or any party to this application directly or indirectly own, operate or
control more than 2 commercial television and 6 commercial radio stations?

Yes

No

ii. would the applicant or any party to this application directly or indirectly own, operate or
control more than I commercial television and 7 commercial radio stations?

Yes

No

iii. if
the
commercial television and 7 commercial radio stations, is the television station located in a
market which the applicant or any party to this application could not directly or indirectly
own, operate or control 2 commercial television stations pursuant to 47 C.F.R. Section
73.3555(b)?

applicant

If ''Yes'' to Question 2*
a. where there are 20 or more independently-owned media voices in the television and radio
markets, as defined by 47 C.F.R. Section 73.3555(c)(3), at the time of the filing of this
application,
i.

b. where there are 10, but fewer than 20, independently-owned media voices in the television and
radio markets, as defined by 47 C.F.R. Section 73.3555(c)(3), at the time of the filing of this
application,
i. would the applicant or any party to this application directly or indirectly own, operate or
control more than 2 commercial television and 4 commercial radio stations?

Yes

No

If ''Yes'' to Question 2(a), (i), (n), or (iii), or to Question 2(b)(i), the applicant must mark ''No''
to Section 11, Item 4a and submit an exhibit stating the reasons in support of an exemption
from, or waiver of, the Commission's joint television and radio ownership regulations.

FCC 2100 Worksheet 2 (Page 7)

IV. CROSS OWNERSHIP
This section of the worksheet may be used in connection with Section II, Item 4b of FCC Form 301 when the applicant will have
newspaper interests in the same local market as the station(s) it seeks to acquire.
(A)

(B)

Will the grant of this application result in the applicant or any party to this application having or maintaining an attributable
interest in a newspaper which: (1) is published four or more days per week, (2) is in the dominant language in the market,
and (3) is published in a community entirely encompassed by:
a. the 1 mV/m contour of one of the FM station(s)?

Yes

No

b. the 2 mV/m contour of one of the AM station(s)?

Yes

No

c. the Grade A contour of one of the commercial television station(s)?

Yes

No

Yes

No

If "Yes," to question (A), has the Commission made a presumptive finding pursuant to Section
310(d) of the Communications Act that the proposed newspaper/broadcast combination is in the
public interest?

If the applicant answered "Yes" to Question A and "No" to Question B, then the applicant must mark "No" to Section II, Item 4b
and submit an exhibit stating the reasons why a waiver of the Commission's newspaper /broadcast cross-ownership rule complies
with the Commission's public interest standard and the criteria set out in 2006 Quadrennial Media Ownership Order 23 FCC Rcd
2010.
In making a public interest finding, the Commission shall presume that it is not inconsistent with the public interest for an entity
to own a daily newspaper in a top 20 Nielsen Designated Market Area ("DMA") and one commercial AM, FM, or TV broadcast
station whose relevant contour encompasses the entire community in which such newspaper is published, provided that, with
respect to a combination including a commercial TV station, (1) the station is not ranked among the top four TV stations in the
DMA, based on the most recent all-day (9 a.m.-midnight) audience share, as measured by Nielsen Media Research or by any
comparable professional, accepted audience ratings service; and (2) at least 8 independently owned and operating major media
voices would remain in the DMA in which the community of license of the TV station in question is located. For purposes of the
newspaper/broadcast cross-ownership rule, major media voices include full-power TV broadcast stations and major newspapers.
2006 Quadrennial Ownership Order, 23 FCC Rcd at 2042-47, 57-62.
In making a public interest finding, the Commission shall presume that it is inconsistent with the public interest for an entity to
own a daily newspaper and an AM, FM, or TV broadcast station whose relevant contour encompasses the entire community in
which such newspaper is published in a DMA other than the top 20 Nielsen DMAs or in any circumstance not discussed above.
In order to overcome the negative presumption with respect to the combination of a major newspaper and a television station, the
applicant must show by clear and convincing evidence that the co-owned major newspaper and station will increase the diversity
of independent news outlets and increase competition among independent news sources in the market. The following factors will
inform this decision. The Commission shall consider (1) whether the combined entity will significantly increase the amount of
local news in the market; (2) whether the newspaper and the broadcast outlets each will continue to employ its own staff and
each will exercise its own independent news judgment; (3) the level of concentration in the DMA; and (4) the financial condition
of the newspaper or broadcast station, and if the newspaper or broadcast station is in financial distress, the proposed owner's
commitment to invest significantly in newsroom operations. 2006 Quadrennial Ownership Order, 23 FCC Rcd at 2049-55,
68-75.
The negative presumption shall be reversed if the newspaper or broadcast station is failed or failing. In order to qualify as failed,
the newspaper or broadcast outlet has to have stopped circulating or have been dark for at least four months immediately prior to
the filing of the assignment or transfer of control application, or must be involved in court-supervised involuntary bankruptcy or
involuntary insolvency proceedings. To qualify as failing, the applicant must show that (1) the broadcast station has had a low
all-day audience share (i.e., 4 percent or lower), (2) the financial condition of the newspaper or broadcast station is poor (i.e., a
negative cash flow for the previous three years), and (3) the combination will produce public interest benefits. In addition, in
both instances, the applicant must show that the in-market buyer is the only reasonably available candidate willing and able to
acquire and operate the failed or failing newspaper or station and that selling the newspaper or station to any out-of-market buyer
would result in an artificially depressed price. 2006 Quadrennial Ownership Order, 23 FCC Rcd at 2047-48, 65.
The negative presumption shall also be reversed if the combination is with a broadcast station that was not offering local
newscasts prior to the combination, and the station will initiate at least seven hours per week of local news programming after the
combination. 2006 Quadrennial Ownership Order, 23 FCC Rcd at 2049, 67.
Applicants should refer to the 2006 Quadrennial Ownership Order, 23 FCC Rcd at 2040-54, 53-75.
FCC 2100 Worksheet 2 (Page 8)

B. FAMILY RELATIONSHIPS
This section of the worksheet may be used in connection with Section II, Item 4c.1 of FCC Form 301, which requires the applicant
to certify that the proposed acquisition does not ''present an issue'' under the Commission's policies relating to media interests of
immediate family members (i.e., husband, wife, father, mother, brother, sister, son or daughter).
The Commission does not prohibit, but rather considers relevant, media interests owned by immediate family members.
Accordingly, the applicant should examine the media interests of its 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, brother, sister, son 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 market?

Yes

No

A broadcast station and a daily newspaper are considered to be in the same area if (1) the predicted
or measured 2 mV/m contour of an AM station encompasses the entire community in which such
daily newspaper is published; (2) the predicted 1 mV/m contour of an FM station encompasses the
entire community in which such daily newspaper is published; or (3) the Grade A contour of a TV
station encompasses the entire community in which such 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 as being circulated generally. See 47 C.F.R. § 73.3555(d) and 47 C.F.R. § 73.3555 Note
6.
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 in
negotiations for the construction of the station?

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-market 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 applicant answers ''No'' to all of the above questions, applicant may conclude that it complies with the Commission's policies
relating, to media interests of immediate family members. If applicant answers ''Yes'' to any one of the above questions, the
applicant must mark ''No'' to Section II, Item 4c and should submit an exhibit giving full particulars, including the family
relationship involved and a detailed account of the business or media relationship between family members.

FCC 2100 Worksheet 2 (Page 9)

C. FUTURE OWNERSHIP RIGHTS
This section of the worksheet may be used in connection with Section II, Item 4c.2, which requires the applicant to certify that the
proposed acquisition complies with the Communications Act and the Commission's regulations and policies concerning future
ownership rights in broadcast stations.
Section 310(d) of the Communications Act of 1934, as amended, prohibits assignment, transfer or any disposition of a broadcast
license without first applying to the Commission and receiving approval prior to any disposition of the license. Similarly,
Commission precedent currently prohibits (1) pledge of a broadcast license as collateral for a loan, or (2) grant of a security interest
(or any similar encumbrance) in a broadcast license. These inquiries are directed to current and prospective third-party interests in
the applicant.
In order to certify compliance with Section II, Item 4c.2 of FCC Form 301, the applicant should review the following questions:
1.

Are there any documents, instruments, contracts, or understandings relating to future ownership
rights in the applicant or any party to the application including, but not limited to: (1) stock
pledges-, (2) security agreements; (3) non-voting stock interests; (4) beneficial stock ownership
interests; (5) options; (6) warrants; or (7) debentures?

Yes

No

Yes

No

If ''No,'' applicant may certify compliance with the future ownership inquiry.
If ''Yes,'' proceed to the questions below.
2.

Is there any provision in the agreements which provides for a security interest in the station
license(s), permits or authorizations?
The response to Question 2 must be ''No'' in order to certify that the contractual documents ''comply
fully with the Commission's rules and policies.''
Note: Under existing precedent, it is permissible to grant a security interest in the proceeds of the
sale of a station license, permit, or authorization, but not in the license, permit, or authorization
itself.

3.

Do the agreements contain a stock pledge?

Yes

No

(a) If ''Yes,'' do the agreements expressly state that voting rights will remain with the applicant, even
in the event of default?

Yes

No

(b) If ''Yes,'' do the agreements indicate that, in the event of default, there will be either a public
(i,e., auction) or private arm's-length sale of the pledged interests?

Yes

No

Yes

No

(c) If ''Yes,'' do the agreements provide that, prior to the exercise of stockholder rights by the
purchaser at such public or private sale, prior consent of the Commission (pursuant to 47 U.S.C.
§310(d)) will be obtained?
If the answer to (a), (b), or (c) is ''No,'' the applicant must mark ''No'' to Section II, Item 4c and
submit an exhibit providing all details of the stock pledge agreement and demonstrating how the
agreement is not violative of Section 73.1150 and Commission precedent.

FCC 2100 Worksheet 2 (Page 10)

4.

If the agreements contain provisions relating to the acquisition of non-voting stock interests,
beneficial stock interests, warrants, debentures convertible into voting or non-voting stock, would
the exercise of those interests, individually or in the aggregate, effectuate a positive or negative
transfer of control of the applicant/applicant?

Yes

No

If ''Yes,'' the agreements must clearly indicate that, prior to the acquisition, exercise, or conversion
of any future interest into equity that would effectuate a positive or negative transfer of control,
prior Commission approval will be sought and received. if they do not, the applicant must mark
''No'' to Section II, Item 4c, and submit an explanatory exhibit providing all details and explaining
how the agreements do not violate Commission policy or precedent.

FCC 2100 Worksheet 2 (Page 11)

D. TIME BROKERAGE/LOCAL MARKETING AGREEMENTS /JOINT SALES AGREEMENTS
This worksheet may be used in connection with the certification in Section II, Item 4a of FCC Form 301. It is intended for use when
the applicant's agreements with lenders, potential investors, or other third parties include a ''time brokerage agreement,'' ''local
marketing agreement,'' any other document pursuant to which that party will provide programming for the subject station, or a joint
sales agreement.
1.

Does or, as a result of this transaction, will the applicant or any party to this application, supply
more than 15 percent of another, same-market station's weekly program hours?

Yes

No

Yes

No

(a) retain the right to reject/substitute programming (including commercial advertising) without
excessive fee or penalty?

Yes

No

(b) retain the right to terminate the agreement without excessive fee or penalty?

Yes

No

Yes

No

(d) retain the obligation to prepare and file the quarterly issues/programs list?

Yes

No

(e)

retain the responsibility to comply with the Commission's political programming rules?

Yes

No

(f)

retain the obligation to pay station expenses?

Yes

No

Yes

No

Yes

No

If ''Yes,'' that interest is attributable to the applicant and must be considered in certifying
compliance with the Commission's multiple ownership rules.
2.

Does the applicant hold a time brokerage agreement, local marketing agreement or joint sales
agreement pursuant to which an entity with an attributable interest in another broadcast station in the
market supplies programming or sells commercial advertising time comprising more than 15% of
the proposed station's weekly program hours?

3.

Has the applicant retained sufficient rights and obligations over the station's proposed personnel,
programming, and finances such that it would retain control of the station under applicable
Commission precedent, i.e., does the applicant:

(c)

retain responsibility for broadcasting programming to meet local needs?

(g) retain the obligation to maintain the station's main studio and staff that studio with at least one
management- level and one staff-level employee, Monday through Friday during regular
business hours?
If the response to any of these questions is ''No,'' the agreement may not comport with existing
Commission precedent. The applicant should therefore mark ''No'' in the appropriate certification
and supply an exhibit explaining how the agreement would not amount to a premature assumption
of control.
4.

Does the programming agreement or joint sales agreement extend beyond one full license term (i.e.,
eight years)?
If ''Yes,'' the agreement may exceed the length allowable under Commission precedent. The
applicant must therefore mark ''No'' to Section II, Item 4a, and submit an exhibit containing the
complete agreement (with all attachments) and discussing how its operation would comply with
precedent.
NOTE: All applicants required to demonstrate compliance with 47 C.F.R. Section 73.3555(a) must
submit, with this application, complete copies of all attributable radio time brokerage/local
marketing and radio joint sales agreements for the subject station or any other stations in the same
market as the subject station.

FCC 2100 Worksheet 2 (Page 12)

E. INVESTOR INSULATION AND NON-PARTY INFLUENCE OVER ASSIGNEE/APPLICANT
This section of the worksheet may be used in connection with Section II, Item 4c.3, which requires the applicant to certify that it
complies with the Commission's restrictions relating to the insulation and non-participation of non-party investors and creditors. See
e.g., Report and Order in MM Docket Nos. 94-150, 92-5 1, and 87-154, FCC 99-207, released August 6, 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 assignee 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

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

c.

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 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.

FCC 2100 Worksheet 2 (Page 13)

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 creditor or any bond, debenture or warrant holder the right to share in the profits
of the applicant;

Yes

No

7.

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

8.

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

9.

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 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
submit an exhibit detailing the rights of the lender and the obligations of the applicant for each loan
agreement.

FCC 2100 Worksheet 2 (Page 14)

(DRAFT COPY - Not for submission)

File Number:

New DTV Station Construction Permit
Application
Facility ID:

General
Information

Status:

Section
Application Description

Status Date:

FRN:

Question

Response

Description of the application (255 characters max.) is visible only
to you and is not part of the submitted application. It will be
displayed in your Applications workspace.

Attachments

Are attachments (other than associated schedules) being filed
with this application?

Fees, Waivers,
and Exemptions

Section
Fees

Question
Is the applicant exempt from FCC application Fees?
Indicate reason for fee exemption:
Is the applicant exempt from FCC regulatory Fees?

Waivers

Does this filing request a waiver of the Commission's rule(s)?
Total number of rule sections involved in this waiver request:
Are the frequencies or parameters requested in this filing covered
by grandfathered privileges, previously approved by waiver, or
functionally integrated with an existing station?

Response

Applicant
Information

Applicant Name, Type, and Contact Information
Applicant

Address

Phone

Email

Applicant Type

Authorization Holder Name
Check box if the Authorization Holder name is being updated because of the sale (or transfer of control) of the Authorization(s) to
another party and for which proper Commission approval has not been received or proper notification provided.

Contact
Representatives

Alien
Ownership

Question

Response

1) Is the applicant a foreign government or the representative of any foreign government as specified in Section 310(a) of
the Communications Act?
2) Is this application, as provided for under Section 310(b) of the Communications Act, for a broadcast, common carrier,
aeronautical en route, or aeronautical fixed radio station Authorization?
3) Is the applicant an alien or the representative of an alien? (Section 310(b)(1))
4) Is the applicant a corporation, or non-corporate entity, that is organized under the laws of any foreign government?
(Section 310(b)(2))
5) Is the applicant an entity of which more than one-fifth of the capital stock, or other equity or voting interest, is owned of
record or voted by aliens or their representatives or by a foreign government or representative thereof or by any entity
organized under the laws of a foreign country? (Section 310(b)(3))
6) Is the applicant directly or indirectly controlled by any other entity of which more than one-fourth of the capital stock, or
other equity or voting interest, is owned of record or voted by aliens, their representatives, or by a foreign government or
representative thereof, or by any entity organized under the laws of a foreign country? (Section 310(b)(4))
7) Has the applicant received a ruling(s) under Section 310(b)(4) of the Communications Act with respect to the same radio
service involved in this application?
8) Has there been any change in the applicant's foreign ownership since issuance of the declaratory ruling(s) cited in
response to Question 7?
8a) Enter the File or Docket Number of the Petition for Declaratory Ruling that the applicant has filed for its foreign
ownership in connection with this application pursuant to Section 310(b)(4) of the Communications Act. It is not
necessary to file a request for a foreign ownership declaratory ruling if the applicant attaches a showing that the
requested authorization(s) is exempt from the provisions of Section 310(b)(4).
9) Does the applicant’s foreign ownership comply with the declaratory ruling(s) cited in response to Question 7?

Basic
Qualifying
Questions

Section
Revoked Application

Question
Has the Applicant or any party to this application had any FCC
station Authorization revoked or had any application for an initial,
modification or renewal of FCC station Authorization denied by the
Commission?

State or Federal Convictions

Has the Applicant or any party to this application, or any party
directly or indirectly controlling the Applicant, ever been convicted
of a felony by any state or federal court?

Response

Channel and
Facility
Information

Section
Proposed Community of

Question

Response

Facility ID

License
State
City
DTV Channel
Facility Type

Facility Type
Station Type

Zone

Antenna
Location Data

Section

Zone

Question

Antenna Structure

Do you have an FCC Antenna Structure Registration (ASR)

Registration

Number?

Response

ASR Number
Coordinates (NAD83)

Latitude

--

Longitude

--

Structure Type
Overall Structure Height
Support Structure Height
Ground Elevation (AMSL)
Antenna Data

Height of Radiation Center Above Ground Level
Height of Radiation Center Above Average Terrain
Height of Radiation Center Above Mean Sea Level
Effective Radiated Power

Antenna
Technical Data

Section
Antenna Type

Question
Antenna Type
Do you have an Antenna ID?
Antenna ID

Antenna Manufacturer and

Manufacturer:

Model
Model
Electrical Beam Tilt
Mechanical Beam Tilt
toward azimuth
Polarization
DTV and DTS: Elevation

Does the proposed antenna propose elevation radiation patterns

Pattern

that vary with azimuth for reasons other than the use of
mechanical beam tilt?
Rotation
Uploaded file for elevation antenna (or radiation) pattern data

Response

Parties to the
Application

Attributable
Interest

Section

Question

Equity and Financial

Applicant certifies that equity and financial interests not set forth

Interests

by the applicant parties are non-attributable.

Multiple Ownership

Is the applicant or any party to the application the holder of an
attributable radio joint sales agreement or an attributable radio or
television time brokerage agreement in the same market as the
station subject to this application?
Applicant certifies that the proposed facility complies with the
Commission's multiple ownership rules and cross-ownership
rules.
Applicant certifies that the proposed facility:
(a ) does not present an issue under the Commission's policies
relating to media interests of immediate family members;
(b) complies with the Commission's polices relating to future
ownership interests;
(c) complies with the Commission's restrictions relating to the
insulation and non-participation of non-party investors and
creditors
Does the Applicant claim status as an "eligible entity," that is, an
entity that qualifies as a small business under the Small Business
Administration's size standards for its industry grouping (as set
forth in 13 C.F.R. § 121-201), and holds:
(a) 30 percent or more of the stock or partnership interests and
more than 50 percent of the voting power of the corporation
or partnership that will own the media outlet; or
(b) 15 percent or more of the stock or partnership interests
and more than 50 percent of the voting power of the
corporation or partnership that will own the media outlet,
provided that no other person or entity owns or controls
more than 25 percent of the outstanding stock or
partnership interests; or
(c) more than 50 percent of the voting power of the
corporation that will own the media outlet (if such
corporation is a publicly traded company)?

Response

Construction
Permit
Certifications

Section
Environmental Effect

Question
Would a Commission grant of Authorization for this location be an
action which may have a significant environmental effect? (See
Section 1.1306 of 47 C.F.R.)

Broadcast Facility

The proposed facility complies with the applicable engineering
standards and assignment requirements of 47 C.F.R. Sections
73.616, 73.622(i), 73.623(e), 73.625, 73.1030, and 73.1125.

Response

Legal
Certifications

Section
Character Issues

Question
Has the Applicant or any party to the application:
(1) had any interest in, or connection with 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
(2) had any pending broadcast application in which character
issues have been raised?

Adverse Findings

Has the Applicant or any party to this application had an adverse
finding or an adverse final action taken by any court or
administrative body in a civil or criminal proceeding brought under
any law related to the following: any felony; mass media-related
antitrust or unfair competition; fraudulent statements to another
governmental unit; or discrimination?

Program Service

Applicant certifies that it is cognizant of and will comply with its

Certification

obligations as a Commission licensee to present a program
service responsive to the issues of public concern facing the
station's community of license and service area.

Local Public Notice

Applicant certifies that it has or will comply with the public notice
requirements of 47 C.F.R. Section 73.3580.

Auction Authorization

Is the applicant submitting an application to obtain a construction
permit as a result of winning an auction?

Equal Employment

If the applicant proposes to employ five or more full-time

Opportunity (EEO)

employees, applicant certifies that it is filing simultaneously with
this application a Model EEO Program Report.

Response

Certification

Section

Question

General Certification

The Applicant waives any claim to the use of any particular

Statements

frequency or of the electromagnetic spectrum as against the
regulatory power of the United States because of the previous use
of the same, whether by authorization or otherwise, and requests
an Authorization in accordance with this application (See Section
304 of the Communications Act of 1934, as amended.).
The Applicant certifies that neither the Applicant nor any other
party to the application is subject to a denial of Federal benefits
pursuant to §5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C.
§862, because of a conviction for possession or distribution of a
controlled substance. This certification does not apply to
applications filed in services exempted under §1.2002(c) of the
rules, 47 CFR . See §1.2002(b) of the rules, 47 CFR §1.2002(b),
for the definition of "party to the application" as used in this
certification §1.2002(c). The Applicant certifies that all statements
made in this application and in the exhibits, attachments, or
documents incorporated by reference are material, are part of this
application, and are true, complete, correct, and made in good
faith.

Authorized Party to Sign

FAILURE TO SIGN THIS APPLICATION MAY RESULT IN
DISMISSAL OF THE APPLICATION AND FORFEITURE OF
ANY FEES PAID
Upon grant of this application, the Authorization Holder may be
subject to certain construction or coverage requirements. Failure
to meet the construction or coverage requirements will result in
automatic cancellation of the Authorization. Consult appropriate
FCC regulations to determine the construction or coverage
requirements that apply to the type of Authorization requested in
this application.
WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY
ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR
IMPRISONMENT (U.S. Code, Title 18, §1001) AND/OR
REVOCATION OF ANY STATION AUTHORIZATION (U.S. Code,
Title 47, §312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47,
§503).
I certify that this application includes all required and relevant
attachments.
I declare, under penalty of perjury, that I am an authorized
representative of the above-named applicant for the
Authorization(s) specified above.

Response