Form FCC Form 603 FCC Form 603 FCC Application for Assignment of Authorization or Trans

OMB APPROVED

FCC Form 603 FEDERAL COMMUNICATIONS COMMISSION OMB Control #

3060 -0800

Information and Instructions Est. Avg. Burden

Per Response:

1.75 Hrs

FCC Application for Assignments of Authorization

or Transfers of Control:

Wireless Telecommunications Bureau and

Public Safety Homeland Security Bureau

NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT OF 1974 AND

THE PAPERWORK REDUCTION ACT OF 1995

We have estimated that each response to this collection of information will take on average 1.75 hours. 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 (3060-0800). We will also accept your comments via the Internet if you send them to [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 government may not conduct or sponsor this collection unless it displays a currently valid OMB control number with this notice. This collection has been assigned OMB control number 3060-0800.

The FCC is authorized under the Communications Act of 1934, as amended, to collect the personal information we request in this form. We will use the information you provide to determine whether approving this application is in the public interest. If we believe there may be a violation or potential violation of a statute, FCC regulation, rule or order, your application may be referred to the Federal, state, or local agency responsible for investigating, prosecuting, enforcing or implementing the statute, rule, regulation or order. In certain cases, the information in your application may be disclosed to the Department of Justice or a court or adjudicative body when (a) the FCC; or (b) any employee of the FCC; or (c) the United States Government, is a party to a proceeding before the body or has an interest in the proceeding.

All parties and entities doing business with the Commission must obtain a unique identifying number called the FCC Registration Number (FRN) and supply it when doing business with the Commission. Failure to provide the FRN may delay the processing of the application. This requirement is to facilitate compliance with the Debt Collection Improvement Act of 1996 (DCIA). The FRN can be obtained electronically from the FCC’s website at http://www.fcc.gov or by manually submitting FCC Form 160. FCC Form 160 is available from the FCC’s web site at http://www.fcc.gov/formpage.html, by calling the FCC’s Forms Distribution Center at (800) 418-FORM (3676), or from the FCC’s Fax Information System by dialing (202) 418-0177.

This notice is required by the Privacy Act of 1974, Public Law 93-579, December 31, 1974, 5 U.S.C. Section 552a(e)(3), and the Paperwork Reduction Act of 1995, Public Law 104-13, October 1, 1995, 44 U.S.C. 3507.

General Instructions

Purpose of Form

FCC Form 603 is a multi-purpose form. It is used to request approval for an Assignment of Authorization (Assignment) or Transfer of Control (Transfer) involving licenses in the Wireless Radio Services. This form is also used to provide notification of a consummated Assignment or Transfer that has previously been consented to by the FCC or for which notification but not prior consent is required. The data collected on the form is used by the FCC to determine whether the public interest would be served by approval of the requested Assignment or Transfer.

Each application, amendment, or other request must contain only one Main Form but may contain as few or as many of the optional schedules as necessary.

Main Form

The purpose of the Main Form is to obtain information sufficient to identify the parties to the proposed Assignment or Transfer, establish the parties' eligibility and qualifications for entering into the Assignment or Transfer and classify the filing. The Main Form also contains the required certifications and signature blocks for both the Assignor/Transferor and the Assignee/Transferee. The Main Form is required with every filing.

(Note: The FCC Registration Number must be completed on the Main Form for all application purposes.)

Schedules

In addition to the Main Form, which is required with every filing, completion of certain schedule(s) may also be required. The purposes of the optional schedules are as follows:

Schedule A (Schedule for Licensees that Received Bidding Credits or Participate in the Installment Payment Plan, or Involving Licenses Won in Closed Bidding) This schedule establishes whether unjust enrichment provisions or other restrictions apply.

Schedule B (Schedule for Defined Geographic Areas To Be Partitioned or for Spectrum To Be Disaggregated) This schedule is used for Assignment applications in geographically-licensed services that involve partitioning of the licensed area or disaggregation of the licensed spectrum. This schedule must be used when the partitioned area involves FCC-defined geographic boundaries (i.e., FCC licensing boundaries (Major Trading Areas (MTAs), Basic Trading Areas (BTAs), etc.) or county boundaries.

Schedule C (Schedule for Undefined Geographic Areas To Be Partitioned) This schedule is used for Assignment applications in geographically-licensed services that involve partitioning of the licensed area when the partitioned area cannot be described using FCC-defined geographic boundaries or county boundaries. This schedule must be used to provide the geographic coordinates (latitude and longitude) that depict the periphery of the partitioned area.

Schedule D (Schedule for Notification of Consummation of an Assignment of Authorization or a Transfer of Control) This schedule is used to notify the FCC that a previously consented to Assignment or Transfer has been consummated.

Schedule E (Schedule for Request for Extension of Time To Consummate an Assignment of Authorization or a Transfer of Control) This schedule is used to request additional time to consummate a previously consented to Assignment or Transfer that the parties will not consummate in the time previously allotted to them by the FCC.

Types of Filings

Assignment of Authorization

An Assignment of Authorization involves a change in the identity of the holder of the License and generally entails the changing of the Licensee’s name.

For an Assignment, the Assignor must request approval using FCC Form 603 and generally must receive prior consent (unless the Assignment is Involuntary or a post-consummation notification of a pro forma Assignment) from the FCC before assigning its authorization(s). For additional information regarding Assignments that can be filed without receiving prior consent from the FCC, see the sections titled Involuntary Transactions and Post-Consummation Notifications of Pro Forma Transactions.

Both the Assignor and Assignee must sign the form. In addition, if required pursuant to Section 1.919 of the Commission’s Rules, the Assignee must file FCC Form 602, FCC Ownership Disclosure Information for the Wireless Telecommunications Services, unless a current and up-to-date FCC Form 602 is already on file at the FCC. For information regarding the filing of FCC Form 602, see Sections 1.919, 1.2112 of the Commission’s Rules.

Full Assignment of Authorization

When the authorization for all of the facilities of a station or market is assigned, this is called a “Full” Assignment of Authorization. To apply for a full Assignment, the Assignor must complete the Authorizations To Be Assigned or Transferred section on the Main Form by providing the Call Sign and Radio Service Code for each of the authorizations that are being assigned.

Partial Assignment of Authorization

When the authorization for some, but not all, of the facilities of a station or market is assigned, this is called a “Partial” Assignment of Authorization.

To apply for a partial Assignment of a geographically-licensed authorization, the Assignor must complete the Authorizations To Be Assigned or Transferred section on the Main Form by providing the Call Sign and Radio Service Code for each of the authorizations that are being assigned as well as complete Schedule B and, if applicable, Schedule C.

To apply for a partial Assignment of a site-specific authorization, the Assignor must complete the Authorizations To Be Assigned or Transferred section on the Main Form by providing the Call Sign and Radio Service Code for each of the authorizations that are being assigned as well as complete other portions of the Authorizations To Be Assigned or Transferred section to fully describe the partial Assignment.

Transfer of Control

A Transfer of Control involves (1) a change from less than 50 percent ownership to 50 percent or more ownership of a Licensee or (2) the transfer of controlling interest in the ownership of a Licensee to another party or parties. See Section 1.948(b) of the Commission’s Rules. A Transfer of Control involves a transfer of controlling interest in ownership but generally does not involve the changing of the Licensee’s name. Refer to the applicable FCC rules and decisions for definitions of controlling interest and ownership.

For a Transfer, the Transferor must request approval using FCC Form 603 and generally must receive prior consent (unless the Transfer is Involuntary or a post-consummation notification of a pro forma Transfer) from the FCC before transferring control of the Licensee’s authorization(s). For additional information regarding Transfers that can be filed without receiving prior consent from the FCC, see the sections titled Involuntary Transactions and Post-Consummation Notifications of Pro Forma Transactions.

Both the Transferor and Transferee must sign the form. In addition, if required pursuant to Section 1.919 of the Commission’s Rules, the Transferee must file FCC Form 602, FCC Ownership Disclosure Information for the Wireless Telecommunications Services, unless a current and up-to-date FCC Form 602 is already on file at the FCC.

Involuntary Transactions

An Involuntary Assignment or Transfer involves the death or legal disability of a Licensee, a member of a partnership, or a person directly or indirectly in control of a corporation that is a Licensee. An application for an Involuntary Assignment or Transfer (Item 7 must be ‘Y’, Item 8a must be ‘Involuntary’ and a date must be provided in Item 8b) must be filed within 30 days after the occurrence of such death or legal disability. For additional information, see Section 1.948(g) of the Commission’s Rules. Note: Involuntary applications should also be filed when a Licensee declares bankruptcy.

Post-Consummation Notifications of Pro Forma Transactions

In the case of a non-substantial (pro forma) Assignment or Transfer involving a telecommunications carrier, as defined in Section 153(44) of the Communications Act, prior consent by the FCC is not required provided that the affected license(s) are not subject to unjust enrichment provisions, the Assignment or Transfer does not involve a proxy contest, and the Assignor/Transferor provides notice of the transaction (Item 7 must be ‘Y’, Item 8a must be ‘Voluntary’, Item 9a must be ‘Y’, Item 9b must be ‘Y’ and a date must be provided in Item 9c) within 30 days of completion of the Assignment or Transfer. For additional information, see Section 1.948(c)(1) of the Commission’s Rules.

Notification of Consummation

For an Assignment, the Assignee must sign and submit the FCC Form 603 Main Form and Schedule D within the prescribed time frame outlined below under the section titled 180-Day Period. For a Transfer, the Transferee must sign and submit the FCC Form 603 Main Form and Schedule D within the prescribed time frame outlined below under the section titled 180-Day Period. Note: Notifications of consummation do not have to be filed for post-consummation notifications of a pro forma Assignment or Transfer, or Involuntary Assignment or Transfer.

Note: If parties do not wish to consummate the transaction, the Assignor (for an Assignment) or the Transferor (for a Transfer) may submit an application to withdraw a previously consented to application.

Extension of Time To Consummate

For an Assignment, the Assignor must sign and submit the FCC Form 603 Main Form and Schedule E within the prescribed time frame outlined below under the section titled One Hundred and Eighty-Day Period. For a Transfer, the Transferor must sign and submit the FCC Form 603 Main Form and Schedule E within the prescribed time frame outlined below under the section titled One Hundred and Eighty-Day Period.

180-Day Period

Assignments and Transfers must be consummated and notification provided to the Commission within 180 days of the date of public notice of the FCC consent, and a Notification of Consummation (Main Form and Schedule D) must be filed no later than 30 days after the actual consummation date, unless an Extension of Time To Consummate (Main Form and Schedule E) is filed prior to the expiration of this 180-day period.

Note: If an Assignment or Transfer is not consummated within 180 days of public notice of approval and a timely filed Notification of Consummation is not submitted or a timely filed request for an Extension of Time to Consummate is not submitted, FCC consent to that transaction is no longer valid.

Information Current and Complete

Information filed with the FCC must be kept current and complete. Parties to the application must notify the FCC regarding any substantial and significant changes in the information furnished in the application. See Section 1.65 of the Commission’s Rules.

Applicable Rules and Regulations

Applicants should obtain the relevant parts of the Commission’s Rules, which are located in Part 47 of the Code of Federal Regulations (CFR). Copies of Part 47 CFR may be purchased by contacting the Superintendent of Documents, Government Printing Office, Washington, DC 20402, by calling (202) 512-1800 or by accessing the Government Printing Office’s website at http://www.access.gpo.gov.

Application Fees and Filing Locations

An application fee may be required with this form. To determine the required fee amount, refer to Subpart G of Part 1 of the Commission’s Rules (47 CFR Part 1, Subpart G) and the current Fee Filing Guide. For assistance with fees applicable to the radio services governed by the Commission’s Rules, call (877) 480-3201 (TTY (717) 338-2824). The current Fee Filing Guide can be downloaded from the FCC's website at http://www.fcc.gov/fees, by calling the FCC's Forms Distribution Center at (800) 418-FORM (3676), or from the FCC’s Fax Information System by dialing (202) 418-0177.

Paper applications requiring a fee must be mailed to the Federal Communications Commission, P.O. Box 979097, St. Louis, MO 63197-9000 or hand delivered to the U.S. Bank, Attn: FCC Government Lockbox #979097, SL-MO-C2-GL, 1005 Convention Plaza, St. Louis, MO 63101.

Paper applications not requiring a fee must be mailed to the Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA 17325-7245 or hand delivered to the Federal Communications Commission, 1280 Fairfield Road, Gettysburg, PA 17325-7245.

Submission of Paper-Filed Forms

One original paper copy of this application is required to be filed with the Commission. The Main Form and the applicable schedules should be submitted as one package, stapled in the upper left corner. The Main Form should be first, with the schedules attached in alphabetical order.

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.

Note: Some Commission Rules require Applicants to attach one or more exhibits to an application in addition to the information requested in the application form.

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 8 1/2” by 11” page in length, all information therein is current and accurate in all significant respects, and 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 page references. Items that call for numbers or that can be answered ‘Y’ or ‘N’ or with other short answers must be answered directly without reference to a previous filing.

Assistance with Completing this Form

For assistance with this form, contact the Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA 17325‑7245, or call (877) 480-3201 (TTY (717) 338-2824).

Technical Assistance for Electronic Filers

For technical assistance with filing electronically, contact the FCC at (877) 480-3201.

Instructions for FCC Form 603 Main Form

General Information

Item 1 Indicate the purpose for which the application is being filed by inserting the appropriate two‑letter abbreviation from the following list

(only one purpose may be specified).

AA - Assignment of Authorization

TC - Transfer of Control

AM - Amendment: To amend a previously filed, currently pending application. Use Item 2 to provide the File Number of the previously filed application. All appropriate schedules must be completed and attached, and must accurately reflect the effect and purpose of the amendment.

WD - Withdrawal: To withdraw a previously filed, currently pending or consented to application. Use Item 2 to provide the File Number of the pending or consented to application.

NT - Required Notification: To notify the FCC that, within the required time period, an Assignment or Transfer has been consummated.

EX - Request for Extension of Time: To request additional time to consummate an Assignment or Transfer.

Item 2 If the filing is an amendment or withdrawal of a previously filed application, provide the File Number of the original application. This information can be obtained by using ULS Application Search or by contacting the FCC at (877) 480-3201 (TTY 717-338-2824).

Item 3a Enter ‘Y’ if this application is one in a series of related applications involving other wireless licenses. Otherwise, enter ‘N’.

The purpose of this item is to indicate whether the proposed transaction involves other wireless licenses not listed on this filing that are held by the Licensee, affiliates of the Licensee, or third parties (e.g., spectrum swaps or multi-party transactions). For this purpose, "affiliates" is defined in Section 1.2110(a)(4) of the Commission’s Rules, and includes parents, subsidiaries, or commonly-controlled entities. Where a transaction involves the Assignment or Transfer of multiple licenses held by a single Licensee, a single form should be filed whenever possible. Where a transaction involves the Assignment or Transfer of licenses by affiliated Licensees or third-party Licensees, a separate form must be filed for each Licensee. Parties who seek to assign or transfer licenses as part of a larger transaction or plan on filing multiple applications are strongly encouraged to contact the Wireless Telecommunications Bureau in advance of filing this form.

Item 3b If the response to 3a is ‘Y’ and this filing is the lead application, enter ‘Y’. Otherwise, enter ‘N’.

Item 3c If the response to 3b is ‘N’, provide the File Number of the lead application for this transaction. The lead application should contain an exhibit fully describing the proposed transaction. Any additional applications included as part of the proposed transaction may cross-reference this exhibit.

Item 3d Enter ‘Y’ if the transaction that is the subject of this filing also involves the Assignment or Transfer of non-wireless licenses or authorizations for which Commission approval or notification is required (e.g., Section 214 authorizations, wireline or media authorizations).

Item 4 Enter ‘Y’ if attachments (other than associated schedules) are being filed with this application. Otherwise, enter ‘N’.

Note: Section 310(d) of the Communications Act requires the Commission to determine that the public interest, convenience, and necessity would be served by the proposed Assignment or Transfer. To enable the Commission to make this determination, Applicants may in some instances be required to provide, by means of an attachment, additional information not specifically requested elsewhere on FCC Form 603 to establish the qualifications of the Assignee or Transferee or to otherwise demonstrate that the proposed transaction is in the public interest. The burden is on the Applicants to determine whether such additional information is necessary under Section 310(d) in light of the circumstances of the particular transaction. For example, if: 1) the application involves a non-pro forma Assignment or Transfer of a license in a subscriber-based service, and 2) the proposed Assignee or Transferee, its parent or any affiliate, directly or indirectly owns, controls, or holds an attributable interest in any other entity authorized to provide FCC‑regulated subscriber-based services in a geographic area that overlaps the service area of a license that is the subject of the proposed Assignment or Transfer, the Applicants should generally file an attachment with their FCC Form 603 setting forth the factual circumstances and describing how the proposed transaction meets the public interest standard of Section 310(d). Applicants seeking further guidance on this issue are encouraged to contact the Wireless Telecommunications Bureau in advance of filing FCC Form 603.

Fees and Waivers

Item 5a This item notifies the FCC that the Applicant is exempt from FCC application fees. If the response is ‘Y’, an exhibit demonstrating the Applicant’s eligibility for exemption from FCC application fees must be submitted with this filing. For additional information regarding an Applicant’s eligibility to be exempt from FCC application fees, see the current Fee Filing Guide or call (877) 480-3201 (TTY 717-338-2824).

Item 5b If a request for waiver/deferral of the FCC application fees is being filed with the FCC in conjunction with this filing and the application fees are not being submitted, enter ‘Y’. Otherwise, enter ‘N’. If ‘Y’, attach an exhibit with the date-stamped copy of the waiver/deferral request filed with the Commission’s Office of the Managing Director/Office of General Counsel. Otherwise, enter ‘N’.

Item 6a If the filing includes a request for waiver of the Commission’s Rules (other than FCC application fees), enter ‘Y’ and attach an exhibit specifying the rule section(s) for which a waiver is being requested and demonstrating a justification for the requested waiver. See Section 1.925 of the Commission’s Rules. Otherwise, enter ‘N’.

Item 6b If the response to 6a is ‘Y’, provide the number of rule sections involved (do not enter the actual rule section(s)).

Additional Transaction Information

Item 7a Enter ‘Y’ if the Assignment or Transfer has already occurred. Otherwise, enter ‘N’.

If the response to Item 7a is ‘Y’, the response to Item 8a is Voluntary, and the response to Item 9a or Item 9b is ‘N’, attach an exhibit explaining the circumstances.

Item 7b If the response to Item 7a is ‘Y’, provide the date the event occurred.

Item 8 Indicate whether the Assignment or Transfer is Voluntary or Involuntary by checking the appropriate selection. For additional information regarding involuntary transactions, see Section 1.948(g) of the Commission’s Rules.

Item 9a Enter ‘Y’ in this item if the application is a pro forma Assignment or Transfer. Otherwise, enter ‘N’. If the response to this item is ‘Y’, a response to Item 9b is required.

A pro forma assignment of authorization is one for which the actual controlling party does not change. For example, if an authorization is assigned by one wholly‑owned subsidiary of a parent corporation to another wholly-owned subsidiary of the same corporation, this would be a pro forma Assignment of Authorization.

A pro forma transfer of control is one for which the actual controlling party does not change. For example, a corporate restructuring that changes the chain of ownership to the controlling corporation may give rise to a pro forma Transfer of Control of a Licensee.

Item 9b Enter ‘Y’ if this is a post-consummation notification of a pro forma Assignment or Transfer that is subject to the FCC's forbearance procedures pursuant to Section 1.948(c)(1) of the Commission’s Rules. Otherwise enter ‘N’.

Item 10a For Assignments of Authorization only (purpose AA in Item 1): Enter ‘Y’ if this application is being filed to partition or disaggregate a geographic-area license(s). Otherwise, enter ‘N’. If the response to this item is ‘Y’, Schedule B and, if applicable, Schedule C must be completed. For additional information, see Section 1.948(f) of the Commission’s Rules.

Item 10b For Assignments of Authorization only (purpose AA in Item 1): Enter ‘Y’ if this application is being filed to partially assign a site-based license(s). Otherwise, enter ‘N’. For additional information, see Section 1.948(e) of the Commission’s Rules.

Item 11 This item indicates how the Assignment or Transfer is to be accomplished. If the facilities and other assets are to be sold, answer this item ‘S’. If stock or other ownership interests in the Licensee or entity controlling the Licensee are to be assigned or transferred to another entity, answer this item ‘T’. If the Assignment or Transfer is to be accomplished pursuant to court order (e.g., to an estate, debtor-in-possession, or trustee), answer this item ‘C’. If the Assignment or Transfer is to be accomplished by a court-supervised reorganization, or liquidation, answer this item ‘R’. If the response is ‘O’, explain in an exhibit how the Assignment or Transfer is to be accomplished.

Designated Entity Information

Item 12a Enter ‘Y’ if the Assignment or Transfer involves any licenses that were originally granted before April 25, 2006 and that were awarded with bidding credits within the last five years and/or any licenses that were originally granted after April 25, 2006, and that were awarded with bidding credits within the last ten years. Otherwise, enter ‘N’.

The initial grant date is the date that the license was originally granted by the Commission after an auction, even if the license was acquired in the secondary market. The initial grant date is not the date on which the Commission granted an assignment or transfer of control of the license.

If the response to this item is ‘Y’ the license may be subject to the FCC’s unjust enrichment rules. See Sections 1.2111(d), (e) of the Commission’s Rules. If the response to this item is ‘Y’, Schedule A must be completed.

Item 12b Enter ‘Y’ if the Assignment or Transfer involves a license that was originally awarded subject to the FCC’s installment payment program. Otherwise, enter ‘N’.

If the response to this item is ‘Y’, the license may be subject to the FCC’s unjust enrichment rules. See Sections 1.2111(c), (e) of the Commission’s Rules. If the response to this item is ‘Y’, Schedule A must be completed.

Item 12c Enter ‘Y’ if the Assignment or Transfer involves a license that was originally awarded pursuant to closed bidding within the last five years. Otherwise, enter ‘N’.

If the response to this item is ‘Y’, the license may be subject to assignment or transfer restrictions. See Sections 24.709 and 24.839 of the Commission’s Rules. If the response to this item is ‘Y’, Schedule A must be completed.

Competition Related Information

Item 13 Enter ‘Y’ if this application for Assignment or Transfer involves a license that may be used for interconnected mobile voice and/or data services that would create a geographic overlap with another license, that also could be used to provide interconnected mobile voice and/or data services, in which the Assignee/Transferee already holds direct or indirect interests (of 10 percent or more), either as a Licensee or spectrum lessee/sublessee. Otherwise, enter ‘N’.

Item 14a Enter ‘Y’ if the Assignment or Transfer application involves Cellular Radiotelephone, Broadband PCS, or Specialized Mobile Radio (SMR) license(s) and if the Assignee/Transferee holds a 10 percent or greater direct or indirect interest in any entity that has access (through license authorizations, leases, or subleases) to 10 MHz or more of such spectrum in a geographic area or market. Otherwise, enter ‘N’.

If ‘Y’, specify in an exhibit all geographic areas/markets (e.g., BTA, CMA, county, etc.) where there are spectrum overlaps and the total amount of spectrum that the Assignee/Transferee will hold and/or lease in each geographic area/market.

Item 14b Enter ‘Y’ if the Assignment or Transfer will result in the loss of one or more service provider(s)/competitor(s) in any of the overlap geographic areas/markets. Otherwise, enter ‘N’.

Broadband Radio Service and Educational Broadband Service Information

These items enable the FCC to determine whether the Assignee/Transferee complies with Section 27.1202 of the Commission’s Rules.

Item 15a If the proposed facilities will be used to provide multichannel video programming, enter ‘Y’. Otherwise, enter ‘N’.

Item 15b If response to 15a is ‘Y’, and the Applicants will operate, control or have an attributable interest in a cable television system whose franchise area is located within the geographic service area of the proposed facilities, enter ‘Y’. Otherwise, enter ‘N’.

If ‘Y’, provide an exhibit explaining how the Assignee/Transferee complies with Section 27.1202 of the Commission’s Rules or justifying a waiver of that rule. If a waiver of the Commission’s Rule(s) is being requested, 6a must be answered ‘Y’.

This item enables the FCC to determine whether the Assignee/Transferee complies with Section 27.1202 of the Commission’s Rules.

Item 16 Enter ‘Y’ if the Assignee/Transferee complies with the programming requirements contained in Section 27.1203 of the Commission’s Rules. Otherwise, enter ‘N’.

If ‘N’, provide an exhibit explaining how the Assignee/Transferee complies with Section 27.1203 of the Commission’s Rules or justifying a waiver of that rule. If a waiver of the Commission’s Rule(s) is being requested, 6a must be answered ‘Y’.

Licensee/Assignor Information

Items 17 through 29 identify the person or entity that is applying to assign the authorizations (Assignment of Authorization) or the Licensee in a Transfer of Control.

Item 17 This item indicates the legal entity type of the Assignor (Assignment) or Licensee (Transfer). Select Individual, Unincorporated Association, Trust, Government Entity, Corporation, Limited Liability Company, General Partnership, Limited Partnership, Limited Liability Partnership, Consortium, or Other. When selecting ‘Other’, provide a description of the legal entity.

Item 18 Enter the ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique entity identifier for everyone doing business with the Commission. The FRN can be obtained electronically through the FCC webpage at http://wireless.fcc.gov/uls or by manually submitting FCC Form 160. FCC Form 160 is available for downloading from , by calling the FCC's Forms Distribution Center at (800) 418‑3676, or the FCC’s Fax Information System by dialing (202) 418-0177. Failure to provide the FRN will prevent the Commission from processing the application.

Items 19-27 Complete either Item 19 or Item 20, depending on whether the Assignor/Licensee is an individual or company, respectively. If completing Item 20, enter the individual to contact in Item 21. You may enter a post office box number in Item 22 or a street address in Item 23, or enter information for both items. Enter the city, state, and zip code in Items 24, 25, and 26. Refer to FCC Form 603 Main Form Instructions, Appendix I, for a list of valid state, jurisdiction, and area abbreviations. Enter a telephone number, including area code, in Item 27.

Note: The full legal name is required for Items 19 and 20.

Items 28 and 29 Enter the Assignor/Licensee fax number and e-mail address, if desired and available.

Failure to respond to FCC correspondence sent to the address of record may result in dismissal of an application, liability for forfeiture, or revocation of an authorization.

Demographics of Assignor/Licensee (Optional)

Item 30 The information is optional and is requested for informational purposes only. Responses to this item will in no way affect processing of applications.

Assignor/Licensee Contact Representative

Items 31-41 These items identify the contact representative for the Assignor/Licensee, if different from the Assignor/Licensee. This is usually the headquarters office of a large company, the law firm or other representative of the Assignor/Licensee, or the person or company that prepared or submitted the application on behalf of the Assignor/Licensee. If there is a question about the application, an FCC representative will communicate with the contact representative.

If the contact representative is the same as the Assignor/Licensee, check the box and do not complete the remaining items in this section. If the contact representative is not the same as the Assignor/Licensee, then provide the information and complete this section as follows:

• Either the Individual Name or the Company Name is required.

• If Individual Name is completed, then Company Name and Attention to are not required.

• If Company Name is completed, then either an Individual Name or the Attention to is required.

• Either a PO Box or a Street Address is required. Both may be provided.

• City, State and Zip Code are required.

• Telephone Number is required (including area code).

• FAX Number and E-Mail Address are optional.

Transferor Information (for transfers of control only)

Items 42 through 54 identify the person or entity that is applying for consent to transfer control of the Licensee.

Item 42 This item indicates the legal entity type of the Transferor. Select Individual, Unincorporated Association, Trust, Government Entity, Corporation, Limited Liability Company, General Partnership, Limited Partnership, Limited Liability Partnership, Consortium, or Other. When selecting ‘Other’, provide a description of the legal entity.

Item 43 Enter the Transferor’s ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique entity identifier for everyone doing business with the Commission. The FRN can be obtained electronically through the FCC website 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, by calling (800) 418-FORM (3676), or from Fax Information System by dialing (202) 418-0177. Failure to provide the FRN will prevent the Commission from processing the application.

Items 44-52 Complete either Item 44 or Item 45, depending on whether the Transferor is an individual or company, respectively. If completing Item 45, enter the individual to contact in Item 46. You may enter a post office box number in Item 47 or a street address in Item 48, or enter information for both items. Enter the city, state, and zip code in Items 49, 50, and 51. Refer to FCC Form 603 Main Form Instructions, Appendix I, for a list of valid state, jurisdiction, and area abbreviations. Enter a telephone number, including area code, in Item 52.

Note: The full legal name is required for Items 44 and 45.

Items 53 and 54 Enter the Transferor fax number and e-mail address, if desired and available.

Failure to respond to FCC correspondence sent to the address of record may result in dismissal of an application, liability for forfeiture, or revocation of an authorization.

Demographics of Transferor (Optional)

Item 55 The information is optional and is requested for informational purposes only. Responses to this item will in no way affect processing of applications.

Transferor Contact Representative

Items 56-66 These items identify the contact representative for the Transferor, if different from the Transferor. This is usually the headquarters office of a large company, the law firm or other representative of the Transferor, or the person or company that prepared or submitted the application on behalf of the Transferor. If there is a question about the application, an FCC representative will communicate with the contact representative.

If the contact representative is the same as the Transferor, check the box and do not complete the remaining items in this section. If the contact representative is not the same as the Transferor, then provide the information and complete this section as follows:

• Either the Individual Name or the Company Name is required.

• If Individual Name is completed, then Company Name and Attention To are not required.

• If Company Name is completed, then either an Individual Name or the Attention To is required.

• Either a PO Box or a Street Address is required. Both may be provided.

• City, State and Zip Code are required.

• Telephone Number is required (including area code).

• FAX Number and E-Mail Address are optional.

Assignee/Transferee Information

Items 67 through 81 identify the person or entity that is applying to become or control the Licensee of the authorizations listed in this application. For an Assignment of Authorization, the information provided in these items will become the Licensee’s name, address, and telephone number of record, and the authorizations will be sent to this address. The Assignee is the party that will become the new Licensee if the application is granted. In an application for consent to transfer control of the License, the Transferee is the party that will have a controlling interest in the Licensee.

Item 67 This item indicates the legal entity type of the Assignee or Transferee. Select Individual, Unincorporated Association, Trust, Government Entity, Corporation, Limited Liability Company, General Partnership, Limited Partnership, Limited Liability Partnership, Consortium, or Other. When selecting ‘Other’, provide a description of the legal entity.

Item 68 Enter the Assignee/Transferee’s ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique entity identifier for everyone doing business with the Commission. The FRN can be obtained electronically through the FCC website 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, by calling (800) 418-FORM (3676), or from Fax Information System by dialing (202) 418-0177. Failure to provide the FRN will prevent the Commission from processing the application.

Items 69-70 Complete either Item 69 or Item 70, depending on whether the Assignee/Transferee is an individual or company, respectively.

Note: The full legal name is required for Items 69 and 70.

Item 71 If completing Item 70, enter the contact person for the Assignee/Transferee.

Item 72 Enter the real party in interest’s ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique entity identifier for everyone doing business with the Commission. The FRN can be obtained electronically through the FCC website 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, by calling (800) 418-FORM (3676), or from Fax Information System by dialing (202) 418-0177. If the Assignee or Transferee is also the real party in interest, enter the Assignee’s or Transferee’s FRN in this item. Failure to provide the FRN will prevent the Commission from processing the application.

Item 73 The Assignee or Transferee must identify the real party (parties) in interest. If the Assignee or Transferee is also the real party in interest, enter the Assignee’s or Transferee’s name in this item. If a party other than the Assignee or Transferee is the real party in interest (e.g., a parent or other controlling entity), enter that party's name in this item. If there is more than one real party in interest, attach an exhibit detailing all parties in interest.

The real party in interest is defined as a person who “has an ownership interest, or will be in a position to actually or potentially control the operation of the station.” Astroline Communications Co. Ltd. v. FCC, 857 F.2d 1556, 1564 (D.C. Cir. 1988); see also In Re Applications of Georgia Public Telecommunications Commission, et al., MM Docket No. 89-337, 7 FCC Rcd 7996 ( 1992); In Re Applications of Madalina Broadcasting, et al., MM Docket No. 91-100, 8 FCC Rcd 6344 (1993).

Items 74-79 Enter the address and telephone number of the person to whom the FCC should send correspondence. You may enter a post office box number in Item 74 or a street address in Item 75, or enter information for both items. Enter the city, state, and zip code in Items 76, 77, and 78, respectively. Refer to FCC Form 603 Main Form Instructions, Appendix I, for a list of valid state, jurisdiction, and area abbreviations. Enter a telephone number, including area code, in Item 79.

Items 80 and 81 Enter the Assignee/Transferee fax number and e-mail address, if desired and available.

Failure to respond to FCC correspondence sent to the address of record may result in dismissal of an application, liability for forfeiture, or revocation of an authorization.

Demographics of Assignee/Transferee (Optional)

Item 82 The information is optional and is requested for informational purposes only. Responses to this item will in no way affect processing of applications.

Assignee/Transferee Contact Representative

Items 83-93 These items identify the contact representative for the Assignee/Transferee, if different from the Assignee/Transferee. This is usually the headquarters office of a large company, the law firm or other representative of the Assignee/Transferee, or the person or company that prepared or submitted the application on behalf of the Assignee/Transferee. If there is a question about the application, an FCC representative will communicate with the contact representative.

If the contact representative is the same as the Assignee/Transferee, check the box and do not complete the remaining items in this section. If the contact representative is not the same as the Assignee/Transferee, then provide the information and complete this section as follows:

• Either the Individual Name or the Company Name is required.

• If Individual Name is completed, then Company Name and Attention To are not required.

• If Company Name is completed, then either an Individual Name or the Attention To is required.

• Either a PO Box or a Street Address is required. Both may be provided.

• City, State and Zip Code are required.

• Telephone Number is required (including area code).

• FAX Number and E-Mail Address are optional.

Ownership Disclosure Information

Item 94a Enter ‘Y’ if the Assignee/Transferee is required to file FCC Form 602, Ownership Disclosure Information for the Wireless Telecommunications Services.

Item 94b If 94a is ‘Y’, provide the File Number of the FCC Form 602 submitted in conjunction with this application or already on file with the FCC.

Alien Ownership Questions

These items enable the FCC to determine whether an Applicant is eligible under Section 310(a) and (b) of the Communications Act of 1934, as amended, to hold or have ownership interests in a License.  The Assignee/Post-transfer Licensee is required to answer these questions only if it is filing FCC Form 603 for one of the following purposes indicated in Item 1: Assignment of Authorization or Transfer of Control.  An Assignee/Post-transfer Licensee using FCC Form 603 for any other purpose is not required to answer these questions. Any applicant that answers ‘Y’ to Items 96 – 99a must provide an attachment explaining the circumstances. The FCC will otherwise dismiss the Application without further consideration.

The Commission’s foreign ownership rules for common carrier, aeronautical en route and aeronautical fixed radio station licensees are codified in Sections 1.990 through 1.994 of the Commission’s Rules, 47 C.F.R. §§ 1.990-1.994. See also Review of Foreign Ownership Policies for Common Carrier and Aeronautical Radio Licensees under Section 310(b)(4) of the Communications Act of 1934, as amended, IB Docket No. 11-133, Second Report and Order, FCC 13-50, 28 FCC Rcd 5741 (2013) (“Foreign Ownership Second Report and Order”).

Item 95 The Assignee/Post-transfer Licensee filing FCC Form 603 for one of the purposes indicated above must answer Item 95.  The FCC cannot grant an authorization to a foreign government or the representative of a foreign government.  Therefore, if the true and correct answer to Item 95 is ‘Y’, Assignee/Post-transfer Licensee is not eligible to hold a license and the FCC will dismiss the application without further consideration.

Items 96-97 The FCC cannot grant an authorization to provide common carrier or aeronautical en route service to any Applicant for which the true and correct answer to either of Items 96 or 97 is ‘Y’. Any Applicant that answers ‘Y’ to either of Items 96 or 97 must provide an attachment explaining why the License(s) that is the subject of the application is exempt from the prohibitions contained in § 310(b)(1)-(2) of the Communications Act, 47 U.S.C. § 310(b)(1)-(2). The FCC will otherwise dismiss the application without further consideration.

Item 98 Enter ‘Y’ if the Assignee/Post-transfer Licensee is a corporation of which more than one-fifth of the capital stock is owned of record or voted by aliens or their representatives, or by a foreign government or representative thereof, or by any corporation organized under the laws of a foreign country. Otherwise, enter ‘N’. If the answer is ‘Y’, and if any license(s) to be transferred or assigned would allow for the provision of a common carrier service, it is necessary for the Assignee/Post-transfer Licensee to have or obtain Commission approval. See 47 C.F.R. § 1.990(a)(2). If the answer is ‘Y’, and if any license(s) to be transferred or assigned would allow for the provision of aeronautical en route service, the Applicant must provide an attachment explaining why the requested license is exempt from the prohibitions contained in Section 310(b)(3) of the Communications Act, 47 U.S.C. § 310(b)(3). The FCC will otherwise dismiss the application without further consideration.

While Section 310(b)(3) of the Communications Act prohibits foreign individuals, governments, and corporations from owning more than 20 percent of the capital stock of a broadcast, common carrier, aeronautical en route, and aeronautical fixed radio station licensee, the Commission has determined that it will not apply the 20 percent limit to common carrier licensees in which the foreign investment is held in the licensee through U.S.-organized entities that do not control the licensee, to the extent the Commission determines such foreign ownership is consistent with the public interest. In making a public interest determination, the Commission applies the same policies and procedures that it applies in reviewing foreign ownership that is subject to Section 310(b)(4) of the Communications Act. The Commission adopted this Section 310(b)(3) “forbearance” approach in the Foreign Ownership First Report and Order, IB Docket No. 11-133, FCC 12-93, 27 FCC Rcd 9832 (2012). The Commission codified the forbearance approach in the Foreign Ownership Second Report and Order, IB Docket No. 11-133, FCC 13-50. at ¶¶ 30-37.

The Commission’s Section 310(b)(3) forbearance approach applies only to foreign equity and voting interests that are held, or would be held, in the common carrier Assignee/Post-transfer Licensee through one or more intervening U.S.-organized entities that do not control the Assignee/Post-transfer Licensee. Foreign equity and/or voting interests that are held, or would be held, directly in the Assignee/Post-transfer Licensee, or indirectly other than through an intervening U.S.-organized entity, are not subject to the Commission’s Section 310(b)(3) forbearance approach and shall not be permitted to exceed 20 percent equity or voting interests.

Accordingly, if any license to be transferred or assigned would allow for the provision of a common carrier service, an Assignee/Post-transfer Licensee that answers ‘Y’ to Item 98 must provide an attachment consisting of one of the showings specified in (i), (ii), or (iii) below. The FCC will otherwise dismiss the application without further consideration.

(i) A demonstration that the subject License(s) is exempt from the provisions of Section 310(b)(3);

(ii) A statement that the Assignee/Post-transfer Licensee has received prior Commission approval of its foreign ownership pursuant to the Commission’s Section 310(b)(3) forbearance approach, citation(s) to the relevant declaratory ruling(s) received by the Assignee/Post-transfer Licensee (i.e., DA or FCC Number, FCC Record citation if available, and release date), and a statement specifying that the Assignee/Post-transfer Licensee is in compliance with the terms and conditions of its ruling and with the Commission’s Rules; or

(iii) A copy of a petition for declaratory ruling filed pursuant to Section 1.990(a)(2) of the Commission’s Rules, 47 C.F.R. § 1.990(a)(2), requesting Commission approval of the Assignee/Post-transfer Licensee’s foreign ownership, held through one or more intervening U.S.-organized entities that hold non-controlling equity and/or voting interests in the Assignee/Post-transfer Licensee, along with any foreign interests held in the Assignee/Post-transfer Licensee directly (which shall not exceed 20 percent of its equity interests and/or 20 percent of its voting interests). The petition may be filed electronically on the Internet through the International Bureau Filing System (IBFS) and shall otherwise comport with the requirements of Sections 1.990 through 1.994 of the Commission’s Rules, 47 C.F.R. §§ 1.990-1.994.

With respect to the showing specified in (ii) above, an Assignee/Post-transfer Licensee that is relying on a foreign ownership ruling(s) issued to an “affiliate” pursuant to the Commission’s Section 310(b)(3) forbearance approach and Section 1.990(a)(2) of the Rules, shall include in its showing a certification signed by the affiliate, a U.S.-organized successor-in-interest formed as part of a pro forma reorganization, or a controlling parent company, stating that the affiliate or successor-in-interest is in compliance with the terms and conditions of the foreign ownership ruling(s) and the Commission’s Rules. See Section 1.994(b) of the Rules, 47 C.F.R. § 1.994(b). See also Section 1.990(d)(2) (defining the term “affiliate” for purposes of Sections 1.990-1.994 of the Rules).

Item 99a Enter ‘Y’ if the Assignee/Post-transfer Licensee is directly or indirectly controlled by any other U.S.-organized entity of which more than one-fourth of the capital stock is owned of record or voted by aliens or their representatives, or by a foreign government or representative thereof, or by any corporation organized under the laws of a foreign country. Otherwise, enter ‘N’. If the answer is ‘Y’, and if any license(s) to be transferred or assigned would allow for the provision of a common carrier or aeronautical en route service, it is necessary for the Assignee/Post-transfer Licensee to have or obtain Commission approval of the foreign ownership of its direct and/or indirect controlling U.S.-organized parent company(ies) pursuant to Section 310(b)(4) of the Communications Act , 47 U.S.C. § 310(b)(4). See 47 C.F.R. § 1.990(a)(1); Foreign Ownership Second Report and Order, IB Docket No. 11-133, FCC13-50 ¶¶ 30-37.

Accordingly, any Assignee/Post-transfer Licensee that answers ‘Y’ to Item 99a must provide an attachment consisting of one of the showings specified in (i), (ii), or (iii) below. The FCC will otherwise dismiss the application without further consideration.

(i) A demonstration that the subject License(s) is exempt from the provisions of Section 310(b)(4);

(ii) A statement that the Assignee/Post-transfer Licensee has received prior Commission approval of the foreign ownership of its direct and/or indirect controlling U.S. parent company(ies) pursuant to Section 310(b)(4), citation(s) to the relevant declaratory ruling(s) received by the Assignee/Post-transfer Licensee (i.e., DA or FCC Number, FCC Record citation if available, and release date), and a statement specifying that the Assignee/Post-transfer Licensee is in compliance with the terms and conditions of its ruling and with the Commission’s Rules; or

(iii) A copy of a petition for declaratory ruling filed pursuant to Section 1.990(a)(1) of the Commission’s Rules, 47 C.F.R. § 1.990(a)(1), requesting Commission approval of the foreign ownership of its direct and/or indirect controlling U.S.-organized parent company(ies). The petition may be filed electronically on the Internet through the International Bureau Filing System (IBFS) and shall otherwise comport with the requirements of Sections 1.990 through 1.994 of the Commission’s Rules, 47 C.F.R. §§ 1.990-1.994.

With respect to the showing specified in (ii) above, an Assignee/Post-transfer Licensee that is relying on a foreign ownership ruling(s) issued to an “affiliate” pursuant to Section 310(b)(4) of the Act and Section 1.990(a)(1) of the Rules shall include in its showing a certification signed by the affiliate, a U.S.-organized successor-in-interest formed as part of a pro forma reorganization, or a controlling parent company, stating that the affiliate or successor-in-interest is in compliance with the terms and conditions of the foreign ownership ruling(s) and the Commission’s Rules. See Section 1.994(b) of the Rules, 47 C.F.R. § 1.994(b). See also Section 1.990(d)(2) (defining the term “affiliate” for purposes of Sections 1.990-1.994 of the Rules).

Item 99b An Assignee/Post-transfer Licensee that has answered ‘Y’ to Item 98 and/or Item 99a is required to respond to Item 99b. Item 99b has two purposes. First, Item 99b enables the FCC to determine whether the Assignee/Post-transfer Licensee has attached to its application the appropriate foreign ownership showing required by the Commission’s Foreign Ownership Second Report and Order, IB Docket No. 11-133, FCC 13-50 and the foreign ownership rules adopted in that Order, 47 C.F.R. §§ 1.990-1.994. See Main Form Instructions for Item 98 and Item 99a.

Second, Item 99b enables the FCC to determine whether the application may be eligible for the “immediate approval” procedures in Section 1.948(j)(2) of the Rules, 47 C.F.R. § 1.948(j)(2).

The application may be eligible for the Commission’s immediate approval procedures if the Assignee/Post-transfer Licensee is able to select the first or second option in Item 99b. Specifically, the application may be eligible for the Commission’s immediate approval procedures where the Assignee/Post-transfer Licensee is able to certify that: (1) it is exempt from the provisions of Section 310(b); or (2) it has received a declaratory ruling(s) approving its foreign ownership, and the application involves only the acquisition of additional spectrum for the provision of a wireless service in a geographic coverage area for which the Assignee/Post-transfer Licensee has been previously authorized. See Foreign Ownership Second Report and Order, IB Docket No. 11-133, FCC13-50 ¶¶ 96, 110.

Basic Qualification Questions

Items 100-102 These items enable the FCC to determine whether an Assignee/Transferee is eligible under Sections 310(d) and 308(b) of the Communications Act of 1934, as amended, to hold or have ownership interest in a station license. The Assignee/Transferee is required to answer these questions only if it is filing FCC Form 603 for one of the following purposes indicated in Item 1: Assignment of Authorization or Transfer of Control. An Assignee/Transferee using FCC Form 603 for any other purpose is not required to answer these questions. If the answer to any one or more of Items 100‑102 is ‘Y’, attach as an exhibit a statement explaining the circumstances and a statement giving the reasons why the Assignee/Transferee believes that grant of the application would be in the public interest notwithstanding the actual or alleged misconduct. If the Assignee or Transferee responds ‘Y’ to any question and has previously provided a statement and explanation regarding the circumstances as an attachment to a prior application filed in ULS, and the facts and circumstances are unchanged, the Applicants may refer to the previous application by identifying the application file number and indicating the disposition of the prior application.

Assignor/Transferor Certification Statements

By signing this form, the Assignor/Transferor certifies that the statements listed in this section are true, complete, correct, and made in good faith.

Items 103-105 These items must be completed. To be acceptable for filing, applications and amendments must be signed in accordance with Part 1 of the FCC rules. The signor must be a person authorized to sign the application. Paper originals of applications must bear an original signature. On paper originals, neither rubber-stamped nor photocopied signatures are acceptable. For filers filing electronically via ULS, the electronic signature shall consist of the name of the person authorized to sign typed on the application as a signature.

Assignee/Transferee Certification Statements

By signing this form, the Assignee/Transferee certifies that the statements listed in this section are true, complete, correct, and made in good faith. General Certification (8) is required for applications for licenses for spectrum that is required by Sections 6103, 6401-6403 of the Middle Class Tax Relief and Job Creation Act of 2012, codified at 47 U.S.C. §§ 309, 1413, 1451-1452, to be assigned by a system of competitive bidding under 47 U.S.C. § 309(j). Currently, this certification applies to applications for licenses in radio service AH (AWS, 1915-1920 MHz and 1995-2000 MHz). For purposes of this certification, the term “reasons of national security” means matters relating to the national defense and foreign relations of the United States.

Items 106-108 These items must be completed. To be acceptable for filing, applications and amendments must be signed in accordance with Part 1 of the FCC rules. The signor must be a person authorized to sign the application. Paper originals of applications must bear an original signature. On paper originals, neither rubber-stamped nor photocopied signatures are acceptable. For filers filing electronically via ULS, the electronic signature shall consist of the name of the person authorized to sign typed on the application as a signature.

Authorizations To Be Assigned or Transferred

If this is an application for full Assignment or a Transfer of Control, use this section to identify the authorizations to be assigned (complete only Items 109 (Call Sign), 110 (Radio Service) and 116 (Constructed)). Complete at least one entry in this section and use a separate entry for each authorization. If necessary, attach additional copies of this page to list more authorizations.

If this is an application for a partial Assignment in a site-specific service, use this section to identify the authorizations to be assigned (complete Items 109-116, as appropriate). Complete at least one entry in this section and use a separate entry for each authorization. If necessary, attach additional copies of this page to list more authorizations.

Item 109 In this item list the call signs of the authorizations to be assigned or transferred. Call signs are located on FCC Authorizations.

Note: Assigning call signs without specifying which specific locations, paths (Microwave Services only), or frequencies are to be assigned for that call sign will result in all locations, paths, and frequencies for that call sign being assigned. Use Item 111 to specify which (if any) specific locations are to be assigned. Use Item 112 to specify which (if any) specific paths (Microwave Services only) are to be assigned. Use Items 113, 114 and 115 to specify which (if any) specific frequencies are to be assigned.

Item 110 In this item list the Radio Service of the call sign to be assigned.

Item 111 In this item list the location numbers to be assigned. Location numbers are located on FCC Authorizations.

Note: Assigning locations without specifying which specific frequencies are to be assigned for that location will result in all frequencies at that location being assigned. Use Items 113, 114 and 115 to specify which (if any) specific frequencies are to be assigned.

Item 112 In this item list the path numbers to be assigned (Microwave Services only). Path numbers are located on FCC Authorizations.

Note: Assigning paths without specifying which specific frequencies are to be assigned for that path will result in all frequencies on that path being assigned. Use Items 113, 114 and 115 to specify which (if any) specific frequencies are to be assigned.

Item 113 In this item list the frequency number to be assigned. Frequency numbers are located on FCC authorizations.

Items 114 and 115 In these items list the frequencies, in Megahertz (MHz), to be assigned. Enter the center frequency, or the lower frequency of a frequency band, in Item 114. If applicable, enter the upper frequency of a frequency band in Item 115. Frequencies are located on FCC authorizations or can be located by accessing the Universal Licensing System’s license search.

Item 116 Enter ‘Y’ if the facilities have been constructed. Otherwise, enter ‘N’.

Instructions for Schedule for Licensees that Received Bidding Credits or Participate in the Installment Payment Plan, or Involving Licenses Won in Closed Bidding

FCC Form 603, Schedule A

FCC Form 603 Schedule A is a supplementary schedule. Complete this schedule when an Assignment or Transfer involves a license(s) that was originally awarded through the competitive bidding process and the original Licensee or current Licensee obtained installment payments, bidding credits, or was otherwise subject to special provisions applicable to entrepreneurs, and closed bidding licenses. This schedule establishes whether the Assignee (Assignment of Authorization) or the post-transaction Licensee (Transfer of Control) is eligible for the same special provisions as the current Licensee, or whether unjust enrichment provisions or other restrictions apply.

Bidding Credits

Item 1 Enter ‘Y’ if the full amount of bidding credits awarded with regard to each subject license has been paid as part of unjust enrichment payment(s) in previous transaction(s). Otherwise, enter ‘N’. If ‘Y’ is entered, Item 2 is not required to be completed.

Item 2 Check the appropriate selection: a) the Applicant qualifies for the same designated entity status as the current Licensee; b) the Applicant qualifies for a different designated entity status than the current Licensee; or, c) the Applicant does not qualify for any designated entity status.

If either selection ‘a’ or ‘b’ is checked, attach an exhibit that includes revenue information pursuant to the Commission’s Rules.

Installment Payments

Item 3 Enter ‘Y’ if all installment payments for each subject license have been paid in full. Otherwise, enter ‘N’. If ‘Y’ is entered, Item 4 is not required to be completed.

Item 4 Check the appropriate selection: a) the Applicant qualifies for the same designated entity status as the current Licensee; b) the Applicant qualifies for a different designated entity status than the current Licensee or, c) the Applicant does not qualify for the installment payment plan.

If either selection ‘a’ or ‘b’ is checked, attach an exhibit that includes revenue and asset information pursuant to the Commission’s Rules.

Closed Bidding Licenses

Item 5 Enter ‘Y’ if construction notifications have been submitted for each of the subject licenses. Otherwise, enter ‘N’. If ‘Y’ is entered, Item 6 is not required to be completed.

Item 6 Check the appropriate selection: a) the Applicant qualifies for closed bidding, or b) the Applicant does not qualify for closed bidding.

If selection ‘a’ is checked, attach an exhibit that includes revenue and asset information pursuant to the Commission’s Rules.

Revenue and Asset Information for the Applicants

Item 7 If filing an Amendment application, check the block if modifying the Revenue and Asset Information from what was provided on the original filing. When modifying the data that was provided on the original filing, only enter the items that have changed. This item is not required to be completed on the original filing.

Gross Revenue Disclosure

Most Recent Reportable Year

Item 8a Enter ‘Y’ if the Applicant and any predecessors-in-interest were in existence and had gross revenues for the most recent reportable year. If ‘Y’, complete Items 8b and 8c. Enter ‘N’ if the Applicant and any predecessors-in-interest were not in existence for the most recent reportable year and explain why in an attachment.

One Year Prior to Most Recent Reportable Year

Item 9a Enter ‘Y’ if the Applicant and any predecessors-in-interest were in existence and had gross revenues for one year prior to the most recent reportable year. If ‘Y’, complete Items 9b and 9c. Enter ‘N’ if the Applicant and any predecessors-in-interest were not in existence for one year prior to the most recent reportable year and explain why in an attachment.

Two Years Prior to Most Recent Reportable Year

Item 10a Enter ‘Y’ if the Applicant and any predecessors-in-interest were in existence and had gross revenues for two years prior to the most recent reportable year. If ‘Y’, complete Items 10b and 10c. Enter ‘N’ if the Applicant and any predecessors-in-interest were not in existence for two years prior to the most recent reportable year and explain why in an attachment.

Average Gross Revenue

Item 11 The Universal Licensing System will calculate the average gross revenue for the reported years provided in Items 8, 9 and 10.

Asset Disclosure

Item 12 Enter the total assets disclosed as of the application filing date.

Financial Statements

Item 13 Check if the Applicant used audited financial statements or unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by Applicant’s chief financial officer or the equivalent.

Revenue and Asset Information for Disclosable Interest Holder (DIH)

Item 14 Select the proper block to Add, Modify, or Delete a DIH. If Adding, complete Items 15 through 21. If Modifying, enter only the items changed. If Deleting, complete the Entity Name or the Individual Name and the FRN of the DIH. Modify and Delete are used for Amendments of a previously filed application. If necessary, attach additional copies of this page to list more DIHs.

Disclosable Interest Holder

Item 15 Select the proper block for either Entity Name or Individual name of the Disclosable Interest Holder and provide Entity Name or Individual name and the FCC Registration Number (FRN) of the DIH.

Gross Revenue Disclosure

Most Recent Reportable Year

Item 16a Enter ‘Y’ if the DIH and any predecessors-in-interest were in existence and had gross revenues for the most recent reportable year. If ‘Y’, complete Items 16b and 16c. Enter ‘N’ if the DIH and any predecessors-in-interest were not in existence for the most recent reportable year and explain why in an attachment.

One Year Prior to Most Recent Reportable Year

Item 17a Enter ‘Y’ if the DIH and any predecessors-in-interest were in existence and had gross revenues for one year prior to the most recent reportable year. If ‘Y’, complete Items 17b and 17c. Enter ‘N’ if the DIH and any predecessors-in-interest were not in existence for one year prior to the most recent reportable year and explain why in an attachment.

Two Years Prior to Most Recent Reportable Year

Item 18a Enter ‘Y’ if the DIH and any predecessors-in-interest were in existence and had gross revenues for two years prior to the most recent reportable year. If ‘Y’, complete Items 18b and 18c. Enter ‘N’ if the DIH and any predecessors-in-interest were not in existence for two years prior to the most recent reportable year and explain why in an attachment.

Average Gross Revenue

Item 19 The Universal Licensing System will calculate the average gross revenue for the reported years provided in Items 16, 17 and 18.

Asset Disclosure

Item 20 Enter the total assets disclosed as of the application filing date.

Financial Statements

Item 21 Check if the DIH used audited financial statements or unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by DIHs chief financial officer or the equivalent.

Revenue and Asset Information for Affiliate

Item 22 Select the proper block to Add, Modify, or Delete an Affiliate. If Adding, complete Items 23 through 29. If Modifying, enter only the items changed. If Deleting, complete the Entity Name or the Individual Name and the FRN of the Affiliate. Modify and Delete are used for Amendments of a previously filed application. If necessary, attach additional copies of this page to list more Affiliates.

Affiliate

Item 23 Select the proper block for either Entity Name or Individual name of the Affiliate and provide Entity Name or Individual name and the FCC Registration Number (FRN) of the Affiliate.

Gross Revenue Disclosure

Most Recent Reportable Year

Item 24a Enter ‘Y’ if the Affiliate and any predecessors-in-interest were in existence and had gross revenues for the most recent reportable year. If ‘Y’, complete Items 24b and 24c. Enter ‘N’ if the Affiliate and any predecessors-in-interest were not in existence for the most recent reportable year and explain why in an attachment.

One Year Prior to Most Recent Reportable Year

Item 25a Enter ‘Y’ if the Affiliate and any predecessors-in-interest were in existence and had gross revenues for one year prior to the most recent reportable year. If ‘Y’, complete Items 25b and 25c. Enter ‘N’ if the Affiliate and any predecessors-in-interest were not in existence for one year prior to the most recent reportable year and explain why in an attachment.

Two Years Prior to Most Recent Reportable Year

Item 26a Enter ‘Y’ if the Affiliate and any predecessors-in-interest were in existence and had gross revenues for two years prior to the most recent reportable year. If ‘Y’, complete Items 26b and 26c. Enter ‘N’ if the Affiliate and any predecessors-in-interest were not in existence for two years prior to the most recent reportable year and explain why in an attachment.

Average Gross Revenue

Item 27 The Universal Licensing System will calculate the average gross revenue for the reported years in Items 24, 25 and 26.

Asset Disclosure

Item 28 Enter the total assets disclosed as of the application filing date.

Financial Statements

Item 29 Check if the Affiliate used audited financial statements or unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by Affiliate’s chief financial officer or the equivalent.

Closed Bidding/Designated Entity Eligibility

Total Gross Revenues for Most Recent Reportable Year

Item 30 The Universal Licensing System will calculate the total gross revenue for the most recent reportable year and the year end date.

Total Revenues for One Year Prior to Most Recent Reportable Year

Item 31 The Universal Licensing System will calculate the total gross revenue for one year prior to most recent reportable year and the year end date.

Total Revenues for Two Years Prior to Most Recent Reportable Year

Item 32 The Universal Licensing System will calculate the total gross revenue for two years prior to most recent reportable year and the year end date.

Total Aggregate Average Gross Revenues for Designated Entity

Item 33 The Universal Licensing System will calculate the aggregate average gross revenue for the designated entity.

Total Aggregate Average Gross Revenues for Closed Bidding

Item 34 The Universal Licensing System will calculate the aggregate average gross revenue for the closed bidding.

Total Assets Disclosure

Item 35 The Universal Licensing System will calculate the total assets for the closed bidding.

Instructions for Schedule for Defined Geographic Areas To Be Partitioned or for Spectrum To Be Disaggregated

FCC Form 603, Schedule B

FCC Form 603 Schedule B is a supplementary schedule. Complete this Schedule when an Assignment involves the partitioning or disaggregation of a geographic-area license. Complete a separate schedule for each partitioned area or if additional space is needed to depict the spectrum that is being disaggregated.

Item 1 Enter the Call Sign of the license that is to be partitioned or disaggregated.

Partitioned Area

Item 2 Enter the partitioned area if the partitioned area involves FCC-defined geographic boundaries (i.e., FCC licensing boundaries (Major Trading Areas (MTAs), Basic Trading Areas (BTAs), etc.) or county boundaries.

In some cases, more than one geographic area exists with the same name in the same state (i.e., an independent city with the same name as a county in the same state). To partition these independent cities, you must enter its 5 digit FIPS code (2‑digit state FIPS code + 3‑digit county FIPS code). For example, in Virginia there is a Fairfax County and a Fairfax City. Fairfax City is an independent city and is not affiliated with Fairfax County. To partition the city of Fairfax, you must enter its FIPS code, 51600, as shown in the table below. To partition the county of Fairfax, you could enter its FIPS code or ‘Fairfax, VA’. For a listing of FIPS codes, refer to “www.census.gov/datamap/fipslist/AllSt.txt".

INDEPENDENT CITY NAME FIPS CODE

Baltimore MD 24510

St. Louis, MO 29510

Bedford, VA 51515

Fairfax, VA 51600

Franklin, VA 51620

Richmond, VA 51760

Roanoke, VA 51770

Item 3 If the area to be partitioned is undefined (e.g., cannot be described using FCC-defined geographic boundaries or county boundaries), describe its periphery by completing Schedule C. Assign a unique number to each copy of Schedule C that is filed. Enter this number in both the Number field at the top of Schedule C and Item 3 on Schedule B.

Item 4 Enter the population of the partitioned area.

Spectrum Disaggregated

Item 5 Authorized spectrum blocks can be disaggregated by assigning one or more frequency blocks. To assign a frequency block, enter its lower value in MHz in the Lower Frequency field and enter its upper value in MHz in the Upper Frequency field. In this table, complete as many entries as you need to depict the disaggregation completely.

Coverage Requirements - Partitioning

Item 6 Check the selection that indicates which coverage requirements have been agreed upon by the partitioner and partitionee.

Coverage Requirements - Disaggregation

Item 7 Check the selection that indicates which coverage requirements have been agreed upon by the disaggregator and disaggregatee.

Instructions for Schedule for Undefined Geographic Areas To Be Partitioned

FCC Form 603, Schedule C

FCC Form 603 Schedule C is a supplementary schedule. This schedule must be completed and attached if an undefined area is to be partitioned, as specified by Item 3 on Schedule B. Complete and attach a copy of Schedule C for each Call Sign that is being partitioned or disaggregated. If multiple undefined areas are requested, each undefined area should have a corresponding Schedule C.

This schedule further delineates geographic areas that have not been defined by the FCC. It is used to enter the coordinates of locations that describe the periphery of a geographic area to be partitioned. Specifically, enter up to 300 pairs of latitude/longitude coordinates, one pair for every 3 degrees azimuth around the periphery (you may use additional copies of Page 2 if more space is needed). Coordinates of the specified locations must be referenced to the North American Datum of 1983 (NAD83).

Note: If the area is a defined geographic shape, the Applicants can provide fewer than 300 coordinates, in which case the FCC will assume that these coordinate points are joined by straight lines. For example, a rectangle can be described by four coordinates, a hexagon by six coordinates, and so on.

Number: At the top of this schedule, enter the same number that has been specified in Item 3 of Schedule B.

Latitude: In this column, enter the latitudes of locations using the format DD‑MM‑SS.S‑D, where the degrees (DD) term can have a value in the range of 0 to 72, minutes (MM) can range from 0 to 59, seconds (SS.S) can range from 0 to 59.9, and the direction (D) term is either N for North or S for South.

Longitude: In this column, enter the corresponding longitudes of locations using the format DDD‑MM‑SS.S‑D, where the degrees (DDD) term can have a value in the range of 64 to 180, minutes (MM) can range from 0 to 59, seconds (SS.S) can range from 0 to 59.9, and the direction (D) term is either E for East or W for West.

Instructions for Schedule for Notification of Consummation of an Assignment of Authorization or a Transfer of Control

FCC Form 603, Schedule D

FCC Form 603 Schedule D is a supplementary schedule. This schedule is used to notify the FCC that, within the required time period, either an Assignment of Authorization or a Transfer of Control has been consummated. The FCC Form 603 Main Form must be filed in conjunction with this schedule and signed by either the Assignee (Assignment of Authorization) or the Transferee (Transfer of Control).

Item 1 Provide the file number of the previously consented to Assignment of Authorization or Transfer of Control application.

Item 2 Provide the date that the previously consented to Assignment of Authorization or Transfer of Control was actually consummated.

Instructions for Schedule for Request for Extension of Time To Consummate an Assignment of Authorization or a Transfer of Control

FCC Form 603, Schedule E

FCC Form 603 Schedule E is a supplementary schedule. This schedule is used to request additional time to consummate an Assignment of Authorization or a Transfer of Control. The FCC Form 603 Main Form must be filed in conjunction with this schedule and signed by either the Assignor (Assignment of Authorization) or the Transferor (Transfer of Control).

Item 1 Provide the file number of the previously consented to Assignment of Authorization or Transfer of Control application.

Item 2 Provide the requested consummation date for the Assignment of Authorization or Transfer of Control application. In addition, attach an exhibit explaining the reason for the extension request.

Appendix I

STATE TABLE

Abbreviations for States, Jurisdictions, and Areas

AL Alabama

AK Alaska

AZ Arizona

AR Arkansas

CA California

CO Colorado

CT Connecticut

DE Delaware

DC District of Columbia

FL Florida

GA Georgia

GM Gulf of Mexico

HI Hawaii

ID Idaho

IL Illinois

IN Indiana

IA Iowa

KS Kansas

KY Kentucky

LA Louisiana

ME Maine

MD Maryland

MA Massachusetts

MI Michigan

MN Minnesota

MS Mississippi

MO Missouri

MT Montana

NE Nebraska

NV Nevada

NH New Hampshire

NJ New Jersey

NM New Mexico

NY New York

NC North Carolina

ND North Dakota

OH Ohio

OK Oklahoma

OR Oregon

PA Pennsylvania

RI Rhode Island

SC South Carolina

SD South Dakota

TN Tennessee

TX Texas

UT Utah

VT Vermont

VA Virginia

WA Washington

WV West Virginia

WI Wisconsin

WY Wyoming

AS American Samoa

GU Guam

MP Northern Mariana Islands

PR Puerto Rico

UM U.S. Territories: (Baker Island, Howland Island,

Jarvis Island, Johston Atoll, Kingman Reef, Midway

Island, Navassa Island, Palmyra Atoll and Wake Island)

VI Virgin Islands

AA Armed Forces-Americas (excluding Canada)

AE Armed Forces-(Europe, Middle East, Africa,

Canada)

AP Armed Forces-Pacific

FCC Form 603 FCC Application for Assignments of Authorization or Transfer of Control: Wireless Telecommunications Bureau

Main Form or Transfers of Control: Wireless Telecommunications Bureau

And Public Safety and Homeland Security Bureau Approved by OMB

See instructions for

public burden estimate

General Information

1) Application Purpose (Select only one) ( ) AA - Assignment of Authorization AM - Amendment NT - Required Notification (For Consummation of an Assignment or Transfer) TC - Transfer of Control WD - Withdrawal EX - Request for Extension of Time (To Consummate an Assignment or Transfer)
2) If this application is for an Amendment (AM) or Withdrawal (WD), enter the File Number of the pending or consented to application currently on file with the FCC.	File Number:
3a) Is this application for Assignment of Authorization or Transfer of Control part of a series of applications involving other wireless license(s) held by the Licensee, affiliates of the Licensee (e.g., parents, subsidiaries, or commonly-controlled entities), or third parties that are not included on this application and for which Commission approval or notification is required?	( ) Yes No
3b) If the answer to 3a is ‘Y’, is this filing the lead application?	( ) Yes No
3c) If the answer to 3b is ‘N’, provide the File Number of the lead application.	File Number:
3d) Does this transaction for Assignment of Authorization or Transfer of Control involve the assignment or transfer of non-wireless licenses/authorizations for which Commission approval or notification is required?	( ) Yes No
4) Are attachments (other than associated schedules) being filed with this application?	( ) Yes No

Fees and Waivers

5a) Is the Applicant exempt from FCC application fees? If ‘Y’, attach an exhibit demonstrating how the Applicant is exempt from FCC application fees.	( ) Yes No
5b) Is a waiver/deferral of the FCC application fees being requested and the application fees are not being submitted in conjunction with this application? If ‘Y’, attach a date-stamped copy of the request for waiver/deferral of the FCC application fees.	( ) Yes No
6a) Does this application include a request for waiver of the Commission’s Rules (other than a request for application fee waivers)? If ‘Y’, attach an exhibit specifying the rule section(s) for which a waiver is being requested and including a justification for the waiver request.	( ) Yes No
6b) If 6a is ‘Y’, enter the number of rule sections involved.	Number of Rule Sections: _____________

Additional Transaction Information

7a) Has this application for Assignment of Authorization or Transfer of Control already occurred?	( ) Yes No
7b) If the response to Item 7a is ‘Y’, provide the date the event occurred:	(MM/DD/YYYY) _____/_____/______
8) The Assignment of Authorization or Transfer of Control is:	( ) Voluntary ( ) Involuntary
9a) Is this application a pro forma Assignment of Authorization or Transfer of Control?	( ) Yes No
9b) If Item 9a is ‘Y’, is this a post-consummation notification that is being filed under the Commission’s forbearance procedures pursuant to Section 1.948(c)(1) of the Commission’s Rules?	( ) Yes No
10a) Does this application involve the partitioning and/or disaggregation of geographic-area licenses? If ‘Y’, complete Schedule B and, if applicable, Schedule C.	( ) Yes No
10b) If 10a is ‘N’, does this application involve the partial assignment of site-based licenses?	( ) Yes No

11) How will/has the Assignment of Authorization or Transfer of Control be/been accomplished? Select One: ( )

Sale or other assignment of assets Court order Reorganization or liquidation

Transfer of stock or other ownership interests

Other (voting trust agreement, management contract, etc.): _________________________________________________________________

Designated Entity Information (If 12a, 12b or 12c is ‘Y’, Schedule A is required to be completed.)

12a) Enter ‘Y’ if this application for Assignment of Authorization or Transfer of Control involve any licenses that were originally granted before April 25, 2006, and that were awarded with bidding credits within the last five years and/or any licenses that were originally granted after April 25, 2006, and that were awarded with bidding credits within the last ten years? Otherwise, enter ‘N’. The initial grant date is the date that the license was originally granted by the Commission after an auction, even if the license was acquired in the secondary market. The initial grant date is not the date on which the Commission granted an assignment or transfer of control of the license. If the response to this item is ‘Y’, the licenses may be subject to the FCC’s unjust enrichment rules.  See Section 1.2111(d), (e) of the Commission’s Rules.  If the response to 12a is ‘Y’, Schedule A must be completed.	( ) Yes No
12b) Does this application for Assignment of Authorization or Transfer of Control involve any licenses that were originally subject to the Commission’s installment payment plan?	( ) Yes No
12c) Does this application for Assignment of Authorization or Transfer of Control involve any licenses that were originally granted pursuant to closed bidding within the last five years?	( ) Yes No

Competition Related Information

13) Does this application for Assignment of Authorization or Transfer of Control involve a license(s) that may be used for interconnected mobile voice and/or data services that would, if assigned or transferred, create a geographic overlap with another license(s) in which the Assignee/Transferee already holds direct or indirect interests (of 10 percent or more), either as a Licensee or spectrum lessee/sublessee, and that also could be used to provide interconnected mobile voice and/or data services?	( ) Yes No
14a) Does the Assignee/Transferee hold direct or indirect interests (of 10 percent or more) in any entity that already has access to 10 MHz or more spectrum in the Cellular Radiotelephone, broadband PCS, or Specialized Mobile Radio (SMR) services through license(s), lease(s), or sublease(s) in the same geographic area?	( ) Yes No
14b) Would/does this application for Assignment of Authorization or Transfer of Control reduce the number of entities providing service (using spectrum in any of the three services listed in Item 14a) in the affected market(s)?	( ) Yes No

Broadband Radio Service and Educational Broadband Service Information

15a) Will the requested facilities be used to provide multichannel video programming service?	( ) Yes No
15b) If 15a is ‘Y’, does the Assignee/Transferee operate, control or have an attributable interest (as defined in Section 27.1202 of the Commission’s Rules) in a cable television system whose franchise area is located within the geographic area of the requested facilities? If ‘Y’, provide an exhibit explaining how the Assignee/Transferee complies with Section 27.1202 of the Commission’s Rules or justifying a waiver of that rule. If a waiver of the Commission’s Rule(s) is being requested, 6a must be answered ‘Y’.	( ) Yes No
16) Does the Assignee/Transferee comply with the programming requirements contained in Section 27.1203 of the Commission’s Rules? If ‘N’, provide an exhibit explaining how the Assignee/Transferee complies with Section 27.1203 of the Commission’s Rules or justifying a waiver of that rule. If a waiver of the Commission’s Rule(s) is being requested, 6a must be answered ‘Y’.	( ) Yes No

Assignor/Licensee Information

17) Assignor/Licensee is a(n): (Select One) ( ) Individual ( ) Unincorporated Association ( ) Trust ( ) Government Entity ( ) Corporation ( ) Limited Liability Company ( ) General Partnership ( ) Limited Partnership ( ) Limited Liability Partnership ( ) Consortium ( ) Other: ___________________________________________________________________________________________________________
18) FCC Registration Number (FRN):
19) First Name (if individual):			MI:		Last Name:			Suffix:
20) Legal Entity Name (if not an individual):
21) Attention To:
22) P.O. Box:	And /Or	23) Street Address:
24) City:						25) State:	26) Zip Code:
27) Telephone Number:				28) Fax Number:
29) E-Mail Address:

30) Demographics of Assignor/Licensee (Optional):

Race: ( )American Indian or Alaska Native ( )Asian ( )Black or African-American ( )Native Hawaiian or Other Pacific Islander ( )White

Ethnicity: ( )Hispanic or Latino ( )Not Hispanic or Latino

Gender: ( )Male ( )Female

Assignor/Licensee Contact Representative (if other than Assignor/Licensee)

(____) Check here if same as Assignor/Licensee

31) First Name:			MI:		Last Name:			Suffix:
32) Company Name:
33) Attention To:
34) P.O. Box:	And /Or	35) Street Address:
36) City:						37) State:	38) Zip Code:
39) Telephone Number:				40) Fax Number:
41) E-Mail Address:

Transferor Information (for Transfers of Control only)

42) Transferor is a(n): (Select One) ( ) Individual ( )Unincorporated Association ( )Trust ( )Government Entity ( )Corporation ( )Limited Liability Company ( ) General Partnership ( ) Limited Partnership ( ) Limited Liability Partnership ( ) Consortium ( ) Other: ___________________________________________________________________________________________________________
43) FCC Registration Number (FRN):
44) First Name (if individual):			MI:		Last Name:			Suffix:
45) Legal Entity Name (if not an individual):
46) Attention To:
47) P.O. Box:	And /Or	48) Street Address:
49) City:						50) State:	51) Zip Code:
52) Telephone Number:				53) Fax Number:
54) E-Mail Address:

55) Demographics of Transferor (Optional):

Race: ( )American Indian or Alaska Native ( )Asian ( )Black or African-American ( )Native Hawaiian or Other Pacific Islander ( )White

Ethnicity: ( )Hispanic or Latino ( )Not Hispanic or Latino

Gender: ( )Male ( )Female

Transferor Contact Representative (if other than Transferor)

(____) Check here if same as Transferor.

56) First Name:			MI:		Last Name:			Suffix:
57) Company Name:
58) Attention To:
59) P.O. Box:	And /Or	60) Street Address:
61) City:						62) State:	63) Zip Code:
64) Telephone Number:				65) Fax Number:
66) E-Mail Address:

Assignee/Transferee Information

67) Assignee/Transferee is a(n): (Select One) ( ) Individual ( )Unincorporated Association ( )Trust ( )Government Entity ( )Corporation ( )Limited Liability Company ( ) General Partnership ( ) Limited Partnership ( ) Limited Liability Partnership ( ) Consortium ( ) Other: ___________________________________________________________________________________________________________
68) FCC Registration Number (FRN):
69) First Name (if individual):			MI:		Last Name:			Suffix:
70) Legal Entity Name (if not an individual):
71) Attention To:
72) Real Party in Interest FCC Registration Number (FRN):
73) Name of Real Party in Interest:
74) P.O. Box:	And /Or	75) Street Address:
76) City:						77) State:	78) Zip Code:
79) Telephone Number:				80) Fax Number:
81) E-Mail Address:

82) Demographics of Assignee/Transferee (Optional):

Race: ( )American Indian or Alaska Native ( )Asian ( )Black or African-American ( )Native Hawaiian or Other Pacific Islander ( )White

Ethnicity: ( )Hispanic or Latino ( )Not Hispanic or Latino

Gender: ( )Male ( )Female

Assignee/Transferee Contact Representative (if other than Assignee/Transferee)

(____) Check here if same as Assignee/Transferee.

83) First Name:			MI:		Last Name:			Suffix:
84) Company Name:
85) Attention To:
86) P.O. Box:	And /Or	87) Street Address:
88) City:						89) State:	90) Zip Code:
91) Telephone Number:				92) Fax Number:
93) E-Mail Address:

Ownership Disclosure Information

94a) Is the Assignee/Transferee required to file FCC Form 602, Ownership Disclosure Information for the Wireless Telecommunications Services?	( ) Yes No
94b) If 94a is ‘Y’, provide the File Number of the FCC Form 602 that is required to be submitted in conjunction with this application or is already on file with the FCC.	File Number: ___________________

Alien Ownership (If any answer is ‘Y”, provide an attachment explaining the circumstances. In preparing the attachment, refer to the Main Form Instructions for the “Alien Ownership Questions”.)

95) Is the Assignee/Post-transfer Licensee a foreign government or the representative of any foreign government?	( ) Yes No
96) Is the Assignee/Post-transfer Licensee an alien or the representative of an alien?	( ) Yes No
97) Is the Assignee/Post-transfer Licensee a corporation organized under the laws of any foreign government?	( ) Yes No
98) Is the Assignee/Post-transfer Licensee a corporation of which more than one-fifth of the capital stock is owned of record or voted by aliens or their representatives, or by a foreign government or representative thereof, or by any corporation organized under the laws of a foreign country?	( ) Yes No
99a) Is the Assignee/Post-transfer Licensee directly or indirectly controlled by any other corporation of which more than one-fourth of the capital stock is owned of record or voted by aliens or their representatives, or by a foreign government or representative thereof, or by any corporation organized under the laws of a foreign country?	( ) Yes No
99b) If the answer to 98 or 99a is ‘Y’ select one of the choices below. T he Assignee or Post-transfer Licensee is exempt from the provisions of Section 310(b). It is not necessary to file a petition for declaratory ruling if the Assignee or Post-transfer Licensee includes in the attachment required by Item 98 or Item 99a a showing that the subject License(s) is exempt from the provisions of Section 310(b). T he Assignee or Post-transfer Licensee has received a declaratory ruling(s) approving its foreign ownership, and the application involves only the acquisition of additional spectrum for the provision of a wireless service in a geographic coverage area for which the Assignee or Post-transfer Licensee has been previously authorized. If checked, include in the attachment required by Item 98 or Item 99a the citation(s) of the applicable declaratory ruling(s) by DA/FCC number, the FCC Record citation, if available, release date, and a statement that there has been no change in the foreign ownership of the Assignee or Post-Transfer Licensee since the issuance of its ruling. T he Assignee or Post-transfer Licensee: (i) has received a declaratory ruling(s) approving its foreign ownership, but is not able to make the certification specified immediately above; or (ii) is an “affiliate” of a Licensee or Lessee/SubLessee that received a declaratory ruling(s) under Section 1.990(a) of the Commission’s Rules, 47 C.F.R. § 1.990(a), and is relying on the affiliate’s ruling for purposes of filing this application as permitted under the affiliate’s ruling and Section 1.994(b) of the Rules, 47 C.F.R. § 1.994(b). If checked, and if the Assignee or Post-transfer Licensee received its declaratory ruling(s) on or after August 9, 2013, include in the attachment required by Item 98 or Item 99a the citation(s) of the Assignee or Post-transfer Licensee’s declaratory ruling(s) by DA/FCC number, the FCC Record citation, if available, release date, and a statement that the Assignee or Post-transfer Licensee is in compliance with the terms and conditions of its ruling and with the Commission’s Rules. If checked, and if the Assignee or Post-transfer Licensee received its declaratory ruling(s) prior to August 9, 2013, include in the attachment required by Item 99a a copy of a petition for declaratory ruling filed contemporaneously with the Commission to extend the Assignee or Post-transfer Licensee’s existing ruling(s) to cover the same radio service(s) and geographic coverage area(s) involved in the application. Alternatively, the Assignee or Post-transfer Licensee may request a new declaratory ruling pursuant to Section 1.990(a) of the Commission’s Rules, 47 C.F.R. § 1.990(a). Petitions for declaratory ruling may be filed electronically on the Internet through the International Bureau Filing System (IBFS) (with a copy attached hereto). If checked, and if the Assignee or Post-transfer Licensee is relying on an affiliate’s ruling for purposes of filing this application, include in the attachment required by Item 98 or Item 99a the citation(s) of the applicable declaratory ruling(s) by DA/FCC number, the FCC Record citation, if available, release date, and a statement that the Assignee or Post-transfer Licensee is in compliance with the terms and conditions of the named affiliate’s ruling and with the Commission’s Rules. The Assignee or Post-transfer Licensee must also include a certification of compliance signed by the named affiliate or other qualified entity as specified in Section 1.994(b) of the Rules, 47 C.F.R. § 1.994(b). See Main Form Instructions for Items 98 or 99a, as applicable. T he Assignee or Post-transfer Licensee has not received a declaratory ruling approving its foreign ownership and is requesting a declaratory ruling under Section 1.990(a) of the Commission’s Rules, 47 C.F.R. § 1.990(a), in a petition filed contemporaneously with the Commission. If checked, include in the attachment required by Item 98 or 99a a copy of the petition for declaratory ruling filed contemporaneously with the Commission pursuant to Section 1.990(a) of the Commission’s Rules, 47 C.F.R. § 1.990(a). Petitions for declaratory ruling may be filed electronically on the Internet through the International Bureau Filing System (IBFS) (with a copy attached hereto).

Basic Qualification Information

Has the Assignee/Transferee or any party to this application had any FCC station authorization, license or construction permit revoked or had any application for an initial, modification or renewal of FCC station authorization, license, or construction permit denied by the Commission? If ‘Y’, attach an exhibit explaining the circumstances.	( ) Yes No
Has the Assignee/Transferee or any party to this application, or any party directly or indirectly controlling the Assignee/Transferee ever been convicted of a felony by any state or federal court? If ‘Y’, attach an exhibit explaining the circumstances.	( ) Yes No
102) Has any court finally adjudged the Assignee/Transferee, or any party directly or indirectly controlling the Assignee/Transferee guilty of unlawfully monopolizing or attempting unlawfully to monopolize radio communication, directly or indirectly, through control of manufacture or sale of radio apparatus, exclusive traffic arrangement, or any other means or unfair methods of competition? If ‘Y’, attach an exhibit explaining the circumstances.	( ) Yes No

Assignor/Transferor Certification Statements

1) The Assignor/Transferor certifies either that (1) the authorization will not be assigned or that control of the license(s) will not be transferred until the consent of the Federal Communications Commission has been given, or (2) prior Commission consent is not required because the transaction is subject to streamlined notification procedures for pro forma assignments and transfers by telecommunications carriers. See Section 1.948(c) (1) of the Commission’s Rules.
The Assignor/Transferor 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.
3) The Assignor/Transferor certifies that it is not in default on any payment for Commission licenses and that it is not delinquent on any non-tax debt owed to any federal agency.
Typed or Printed Name of Party Authorized to Sign
103) First Name:	MI:	Last Name:		Suffix:
104) Title:
Signature:			105) Date:
FAILURE TO SIGN THIS APPLICATION MAY RESULT IN DISMISSAL OF THE APPLICATION AND FORFEITURE OF ANY FEES PAID.
WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Title 18, Section 1001) AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Title 47, Section 312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, Section 503).

Assignee/Transferee Certification Statements

1) The Assignee/Transferee certifies either that (1) the authorization(s) will not be assigned or that control of the license(s) will not be transferred until the consent of the Federal Communications Commission has been given, or (2) prior Commission consent is not required because the transaction is subject to streamlined notification procedures for pro forma assignments and transfers by telecommunications carriers. See Section 1.948(c)(1) of the Commission’s Rules.

2) The Assignee/Transferee waives any claim to the use of any particular 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 license or otherwise, and requests an authorization in accordance with this application.

3) The Assignee/Transferee certifies that grant of this application would not cause the Assignee or Transferee to be in violation of any pertinent cross-ownership or attribution rules.*

*If the Assignee/Transferee has sought a waiver of any such rule in connection with this application, it may make this certification subject to the outcome of the waiver request.

4) The Assignee/Transferee agrees to assume all obligations and abide by all conditions imposed on the Assignor/Transferor under the subject authorization(s), unless the Federal Communications Commission pursuant to a request made herein otherwise allows, except for liability for any act done by, or any right accrued by, or any suit or proceeding had or commenced against the Assignor/Transferor prior to this assignment/transfer.

5) The Assignee/Transferee 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.

6) The Assignee/Transferee certifies that neither it nor any other party to the application is subject to a denial of Federal benefits pursuant to Section 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. See Section 1.2002(b) of the Commission’s Rules for the definition of "party to the application" as used in this certification.

7) The Assignee/Transferee certifies that it is not in default on any payment for Commission licenses and that it is not delinquent on any non-tax debt owed to any federal agency.

8) The Assignee/Transferee certifies that it and any of the related individuals and entities required to be disclosed on this application and FCC Form 602 (FCC Ownership Disclosure Information for the Wireless Telecommunications Services) are not person(s) who have been, for reasons of national security, barred by any agency of the Federal Government from bidding on a contract, participating in an auction, or receiving a grant. This certification applies only to applications for licenses for spectrum that is required by Sections 6103, 6401-6403 of the Middle Class Tax Relief and Job Creation Act of 2012, codified at 47 U.S.C. §§ 309, 1413, 1451-1452, to be assigned by a system of competitive bidding under 47 U.S.C. § 309(j).

Typed or Printed Name of Party Authorized to Sign

106) First Name:	MI:	Last Name:		Suffix:
107) Title:
Signature:			108) Date:
FAILURE TO SIGN THIS APPLICATION MAY RESULT IN DISMISSAL OF THE APPLICATION AND FORFEITURE OF ANY FEES PAID.
WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Title 18, Section 1001) AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Title 47, Section 312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, Section 503).

Authorizations To Be Assigned or Transferred

109) Call Sign	110) Radio Service Code	111) Location Number	112) Path Number (Microwave only)	113) Frequency Number	114) Lower or Center Frequency (MHz)	115) Upper Frequency (MHz)	116) Constructed Yes / No

FCC Form 603 Schedule for Licensees that Received Bidding Credits or Approved by OMB

Schedule A Participate in the Installment Payment Plan, 3060 - 0800

or Involving Licenses Won in Closed Bidding See Main Form instructions for

public burden estimate

For Purposes of Schedule A, Applicant is defined as the Assignee (Assignment of Authorization) or the post-transaction Licensee (Transfers of Control)

Bidding Credits

Have the full amount of bidding credits awarded with regard to each of the subject license(s) been paid as part of unjust enrichment payment(s) in previous transaction(s)? If the response to Item 1 is ‘Y’, Item 2 is not required to be completed.	( ) Yes No
2) With respect to each of the subject licenses, the Applicant: ( ) a) qualifies for the same designated entity status as the current Licensee ( ) b) qualifies for a different designated entity status than the current Licensee ( ) c) does not qualify for any designated entity status

Installment Payments

3) Have all the installment payment obligations for each of the subject licenses been paid in full? If the response to Item 3 is ‘Y’, Item 4 is not required to be completed.	( ) Yes No
4) With respect to each of the subject licenses, the Applicant: ( ) a) qualifies for the same eligibility status for the installment payment plan as the current Licensee ( ) b) qualifies for a different eligibility status for the installment payment plan than the current Licensee ( ) c) does not qualify for the installment payment plan

Closed Bidding Licenses

Have construction notifications been submitted as required by the Commission’s Rules for each of the subject licenses? If the response to Item 5 is ‘Y’, Item 6 is not required to be completed.	( ) Yes No
6) With respect to each of the subject licenses, the Applicant: ( ) a) qualifies for closed bidding ( ) b) does not qualify for closed bidding

7. Revenue and Asset Information for Applicant

Purpose ((Check Modify if filing an Amendment application and changing the Revenue and Asset Information from what was provided on the original filing)

□ Modify

Gross Revenue Disclosure

Most Recent Reportable Year

8a) Were the Applicant and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 8b) Gross Revenues $_____________________ (Format: 99,999.99) 8 8c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

One Year Prior to Most Recent Reportable Year

9a) Were the Applicant and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 9b) Gross Revenues $_____________________ (Format: 99,999.99) 9 9c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Two Years Prior to Most Recent Reportable Year

10a) Were the Applicant and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 10b) Gross Revenues $_____________________ (Format: 99,999.99) 10c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Average Gross Revenue

11) Average Gross Revenue of Reported Years: $_____________________________ (Format: 99,999.99)

Asset Disclosure

12) Total Assets as of Application Filing Date: $_____________________________(Format: 99,999.99)

Financial Statements

13. Audited or Unaudited (Check One)

□ The Applicant used audited financial statements.

□ The Applicant used unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by the Applicant’s chief financial officer or the equivalent.

14. Revenue and Asset Information for Disclosable Interest Holder (DIH)

Purpose (Select One)

□ Add □ Modify □ Delete

15) Disclosable Interest Holder

□ Entity Name:				FCC Registration Number (FRN):
□ Individual Name: First	MI	Last	Suffix	FCC Registration Number (FRN):

Gross Revenue Disclosure

Most Recent Reportable Year

16a) Were the DIH and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 16b) Gross Revenues $_____________________ (Format: 99,999.99) 16c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

One Year Prior to Most Recent Reportable Year

17a) Were the DIH and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 17b) Gross Revenues $_____________________ (Format: 99,999.99) 17c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Two Years Prior to Most Recent Reportable Year

18a) Were the DIH and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 18b) Gross Revenues $_____________________ (Format: 99,999.99) 18c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Average Gross Revenue

19) Average Gross Revenue of Reported Years: $_____________________________ (Format: 99,999.99)

Asset Disclosure

20) Total Assets as of Application Filing Date: $_____________________________ (Format: 99,999.99)

Financial Statements

21. Audited or Unaudited (Check One)

□ The DIH used audited financial statements.

□ The DIH used unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by the DIH’s chief financial officer or the equivalent.

22) Revenue and Asset Information for Affiliate

Purpose (Select One)

□ Add □ Modify □ Delete

23) Affiliate

□ Entity Name:				FCC Registration Number (FRN):
□ Individual Name: First	MI	Last	Suffix	FCC Registration Number (FRN):

Gross Revenue Disclosure

Most Recent Reportable Year

24a) Were the Affiliate and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 24b) Gross Revenues $_____________________ (Format: 99,999.99) 24c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

One Year Prior to Most Recent Reportable Year

25a) Were the Affiliate and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 25b) Gross Revenues $_____________________ (Format: 99,999.99) 25c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Two Years Prior to Most Recent Reportable Year

26a) Were the Affiliate and any predecessors-in-interest in existence for a full year of the relevant period? If ‘N’, explain why in an attachment.	( ) Yes No
If ‘Y’, provide the following information. 26b) Gross Revenues $_____________________ (Format: 99,999.99) 26c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Average Gross Revenue

27) Average Gross Revenue of Reported Years: $_____________________________ (Format: 99,999.99)

Asset Disclosure

28) Total Assets as of Application Filing Date: $_____________________________ (Format: 99,999.99)

Financial Statements

29. Audited or Unaudited (Check One)

□ The Affiliate used audited financial statements.

□ The Affiliate used unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by

the Affiliate’s chief financial officer or the equivalent.

Closed Bidding/Designated Entity Eligibility

Total Gross Revenues for Most Recent Reportable Year

30a) Gross Revenues $_____________________ (Format: 99,999.99)

30b) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Total Gross Revenues for One Year Prior to Most Recent Reportable Year

31a) Gross Revenues: $_____________________ (Format: 99,999.99)

31b) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Total Gross Revenues for Two Years Prior to Most Recent Reportable Year

32a) Gross Revenues: $_____________________ (Format: 99,999.99)

32b) Year End Date: _____________________ (Date Format: MM/DD/YYYY)

Total Aggregate Average Gross Revenues for Designated Entity

33) Aggregate Average Gross Revenue: $_____________________ (Format: 99,999.99)

Total Aggregate Average Gross Revenues for Closed Bidding

34) Aggregate Average Gross Revenue: $_____________________ (Format: 99999.99)

Total Assets Disclosure for Closed Bidding

35) Total Assets: $_____________________ (Format: 99,999.99)

FCC Form 603 Schedule for Defined Geographic Areas To Be Approved by OMB

Schedule B Partitioned or for Spectrum To Be Disaggregated 3060-0800

See Main Form instructions for

public burden estimate

1) Partitioner/Disaggregator Call Sign:

Partitioned Area

2) Defined Area To Be Partitioned	3) Undefined Area To Be Partitioned (Complete Schedule C)	4) Population of Partitioned Area
	Schedule C # Attached:

5) Disaggregated Spectrum (in MHz)

Disaggregated Spectrum

Disaggregated Spectrum

Disaggregated Spectrum

Lower Frequency	Upper Frequency	Lower Frequency	Upper Frequency	Lower Frequency	Upper Frequency

6) Coverage Requirements - Partitioning

( ) Option 1 Partitioner and Partitionee will independently meet all construction requirements for their licensed areas.

( ) Option 2 Partitioner will meet all construction requirements for the entire licensed area.

( ) Option 3 Partitioner and Partitionee will share all construction requirements for the entire pre-partitioned licensed area.

Note: Option 3 only applies to 700 MHz licensees in the following channel blocks: Block A in the 698-704 MHz and 728-734 MHz bands, Block B in the 704-710 MHz and 734-740 MHz bands, Block C, C1 and C2 in the 746-757 MHz and 776-787 MHz, and Block E in the 722-728 MHz band.

7) Coverage Requirements - Disaggregation

( ) Option 1 Disaggregator will meet all construction requirements for the entire licensed area.

( ) Option 2 Disaggregatee will meet all construction requirements for the entire licensed area.

( ) Option 3 Disaggregator and Disaggregatee will share responsibility for meeting all construction requirements for the entire licensed area.

FCC Form 603 Schedule for Undefined Areas To Be Partitioned Approved by OMB

Schedule C 3060 - 0800

Number: _____ See Main Form instructions for public burden estimate

For each undefined geographic area, complete up to 300 Latitude/Longitude combinations for every 3 degrees azimuth, using NAD83 Datum. Attach additional Schedule C’s if necessary.

Latitude (DD-MM-SS.S-D) Longitude (DDD-MM-SS.S-D)			Latitude (DD-MM-SS.S-D) Longitude (DDD-MM-SS.S-D)
1			31
2			32
			33
			34
			35
			36
			37
			38
			39
			40
			41
			42
			43
			44
			45
			46
			47
			48
			49
			50
			51
			52
			53
			54
			55
			56
			57
			58
			59
			60

FCC Form 603 Schedule for Undefined Areas To Be Partitioned

Schedule C

Number: _____

Latitude (DD-MM-SS.S-D) Longitude (DDD-MM-SS.S-D)			Latitude (DD-MM-SS.S-D) Longitude (DDD-MM-SS.S-D)
61.			91.
62.			92.
63.			93.
64.			94.
65.			95.
66.			96.
67.			97.
68.			98.
69.			99.
70.			100.
71.			101.
72.			102.
73.			103.
74.			104.
75.			105.
76.			106.
77.			107.
78.			108.
79.			109.
80.			110.
81.			111.
82.			112.
83.			113.
84.			114.
85.			115.
86.			116.
87.			117.
88.			118.
89.			119.
90.			120.

FCC Form 603 Schedule for Notification of Consummation of an Approved by OMB

Schedule D Assignment of Authorization or a Transfer of Control 3060 - 0800

See Main Form instructions

for public burden estimate

1) Provide the File Number of the Assignment of Authorization or Transfer of Control application.	File Number: ___________________
2) Provide the actual date of consummation for the Assignment of Authorization or Transfer of Control.	(MM/DD/YYYY) ____/____/______

FCC Form 603 Schedule for Request for Extension of Time To Approved by OMB

Schedule E Consummate an Assignment of Authorization 3060 - 0800

or a Transfer of Control See Main Form instructions

for public burden estimate

1) Provide the File Number of the Assignment of Authorization or Transfer of Control application.	File Number: ___________________
2) Provide the consummation date for the Assignment of Authorization or Transfer of Control.	(MM/DD/YYYY) ____/____/______

FCC Form 603 – Instructions

January 2015 - Page 3