Form FCC Form 608 FCC Form 608 Schedule A

FCC Application or Notification for Spectrum Leasing Arrangement or Private Commons Arrangement: WT and PSHS Bureaus

1058_Form 608 Schedule A with AMR_120310

FCC Application or Notification for Sectrum Leasing Arrangement or Private Commons Arrangement: WTB and PSHSB

OMB: 3060-1058

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FCC Form 608 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB

Schedule A 3060-1058

Est. Avg. Burden

Information and Instructions Per Response: 5 hours


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 608, Schedule A


Complete this schedule when a Lease/Sublease/Transfer of Control involves spectrum associated with 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 Lessee/Sublessee/Transferee is eligible for the same special provisions as the Licensee, or whether unjust enrichment provisions or other restrictions apply. All filings for Subleases must be filed manually and sent to the appropriate address. The mailing address can be found under the Application Fees and Filing Locations section found on page 8 of the Main Form Instructions.


Designated Entity Information


Bidding Credits

Items 1-3 require information from Licensees and Lessees/Sublessees/Transferees in those instances in which the Lease/Sublease involves spectrum associated with license(s) for which the Licensee is a “designated entity.” See 47 CFR §§ 1.2110-1.2112 (rules pertaining to designated entities); § 1.9020(d)(4), § 1.9030(d)(4) (rules pertaining to leasing involving designated entities); and appropriate FCC competitive bidding rules and applicable service rules in Title 47 of the Code of Federal Regulations (47 CFR).


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 the response to Item 1 is ‘Y’, Items 2 and 3 are not required to be completed. If the response to Item 1 is ‘N’, complete Item 2 or 3, as appropriate.


Bidding Credits – (Spectrum Manager Only)

Item 2 Must be completed for each Application/Notification for a Spectrum Manager Lease/Sublease in which the Licensee has “designated entity” status if the Applicant entered No in Item 1. In general, for purposes of determining whether a licensee retains its eligibility as a designated entity, the gross revenues of the licensee, its “controlling interest(s),” and any “affiliate(s)” of the licensee or of any “controlling interest” are considered on a cumulative basis and aggregated. See 47 CFR §§ 1.2110(b), 1.2112(b). A “controlling interest” includes any individual or entity with either de jure or de facto control of the licensee. See § 1.2110(c)(2). An “affiliate” includes any individual or entity holding an attributable interest in the licensee as set forth in § 1.2110(c)(5). Note that the Commission’s attribution rules relating to “controlling interests” (and the standard for determining de facto control embodied therein) and “affiliates,” as set forth in § 1.2110, are not altered by the different de facto control standard generally applicable to spectrum leasing arrangements, as set forth in § 1.9010 of the Commission’s Rules. See Promoting Efficient Use of Spectrum through Elimination Barriers to the Development of Secondary Markets. WT Docket No. 00-230, 18 FCC Rcd. 20604 (2003) (“Secondary Markets Order”). To the extent that there is any conflict between Section 1.2110 (and the de facto control standard embodied therein) and the de facto control standard in Section 1.9010, the designated entity provisions of § 1.2110 govern with regard to whether a licensee has maintained the requisite degree of ownership and control to allow it to remain eligible for the license or for other benefits such as bidding credits and installment payments. See Secondary Markets Order, 18 FCC Rcd at 20654-55 ¶ 113.


Item 2a Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) has a general partnership interest or has direct or indirect ownership interests in excess of ten percent in the Licensee. Otherwise, enter ‘N’.


Item 2b Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) is a “controlling interest holder” or “affiliate” of the current Licensee. Otherwise, enter ‘N’.


Item 2c Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) shares office space, equipment or other facilities with any party controlling the entity from which spectrum is being leased/subleased. Otherwise, enter ‘N’.


Item 2d Enter ‘Y’ if the Licensee can certify that the Lease/Sublease does not affect its continuing eligibility to retain bidding credits as a designated entity. Enter ‘N’ if the Licensee cannot so certify.

FCC Form 608 – Schedule A Instructions

(Edition Date) - Page 1

Bidding Credits – (Long-Term De Facto Transfer Only)

Item 3 Item 3 must be completed for each Application/Notification for a Long-Term De Facto Transfer Lease/Sublease. Check the appropriate response.


If the Lessee/Sublessee/Transferee qualifies for the same designated entity status as the current Licensee, or qualifies for a higher percentage bidding credit than the current Licensee, it should so indicate by checking the first box. If the Lessee/Sublessee/Transferee qualifies for a designated entity status, but does not qualify for as high a percentage of bidding credits as received by the Licensee, the Lessee/Sublessee/Transferee should respond by checking the second box. If the Lessee/Sublessee/Transferee checks either the second box or if it does not qualify for any designated entity status (and thus checks the third box), an unjust enrichment payment WILL be required. See Secondary Markets Order, 18 FCC Rcd at 10666-67 ¶ 145.


Refer to the appropriate FCC competitive bidding rules, including section 1.2111, and to the service rules in 47 CFR. If the Lessee/Sublessee/Transferee qualifies for designated entity status, it must complete Items 11-39 and attach an exhibit in accordance with 47 CFR disclosing the Lessee/Sublessee/Transferee’s eligibility for bidding credits.


Note that payment of any required unjust enrichment must be provided to the Commission prior to grant of the Application/Notification.


Installment Payment Plan

Items 4-7 require information from Licensees and Lessees/Sublessees/Transferees in those instances in which the Lease/Sublease involves spectrum associated with license(s) for which the Licensee is making installment payments. See 47 CFR §§ 1.2110-1.2112 (rules pertaining to licensees participating in the Commission’s installment payment plan); § 1.9020(d)(4), § 1.9030(d)(4) (rules pertaining to leasing involving designated entities); and appropriate FCC competitive bidding rules and applicable service rules in 47 CFR.


Item 4 Enter ‘Y’ if all installment payment obligations for each of the subject licenses have been paid in full. Otherwise, enter ‘N’. If the response to Item 4 is ‘N’, complete Item 5 and Items 6 or 7 as appropriate.


Item 5 If a Lease/Sublease involves spectrum associated with a license subject to the Commission’s installment payment plan (see § 1.2110 and related service-specific rules in Title 47 of the Code of Federal Regulations (47 CFR)), a Licensee and Lessee/Sublessee/Transferee may enter into a Lease/Sublease only after the Commission-approved financing documents have been executed by both the Licensee and Lessee/Sublessee/Transferee, as required pursuant to Sections 1.9040 and 1.9045, 47 C.F.R. §§ 1.9040, 1.9045). The Licensee and Lessee/Sublessee/Transferee should check the appropriate response to item 5a regarding the execution of Commission-approved financing agreements. If the response to Item 5a is ‘Y’, provide the date of execution of the required document(s) in Items 5b and 5c.


Installment Payment Plan – (Spectrum Manager Leases/Subleases Only)

Item 6 Must be completed for each Application/Notification for a Spectrum Manager Lease/Sublease in which the license(s) associated with the spectrum is subject to the Commission’s installment payment plan. In general, for purposes of determining whether a licensee retains its eligibility to participate in the installment payment plan, the gross revenues of the licensee, its “controlling interest(s),” and any “affiliate(s)” of the licensee or of any “controlling interest” are considered on a cumulative basis and aggregated. See 47 CFR §§ 1.2110(b), 1.2112(b). A “controlling interest” includes any individual or entity with either de jure or de facto control of the licensee. See § 1.2110(c)(2). An “affiliate” includes any individual or entity holding an attributable interest in the licensee as set forth in § 1.2110(c)(5). Note that the Commission’s attribution rules relating to “controlling interest(s)” (and the standard for determining de facto control embodied therein) and “affiliate(s),” as set forth in § 1.2110, are not altered by the different de facto control standard generally applicable to spectrum leasing arrangements, as set forth in § 1.9010 of the Commission’s rules. See Secondary Markets Order, 18 FCC Rcd. 20604. To the extent that there is any conflict between Section 1.2110 (and the de facto control standard embodied therein) and the de facto control standard in Section 1.9010, the provisions of § 1.2110 govern with regard to whether a licensee has maintained the requisite degree of ownership and control to allow it to remain eligible for the license or for other benefits such as bidding credits and installment payments. See Secondary Markets Order, 18 FCC Rcd. at 20654-55 ¶ 113.


Item 6a Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) has a general partnership interest or has direct or indirect ownership interests in excess of ten percent in the Licensee. Otherwise, enter ‘N’.


Item 6b Enter ‘Y” if the Applicant (Lessee/Sublessee/Transferee) is a “controlling interest holder” or “affiliate” of the current Licensee. Otherwise, enter ‘N’.


Item 6c Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) shares office space, equipment or other facilities with any party controlling the entity from which spectrum is being leased/subleased. Otherwise, enter ‘N’.


Item 6d Enter ‘Y’ if the Licensee can certify that the Lease/Sublease does not affect its continuing eligibility to participate in the FCC’s installment payment plan. Enter ‘N’ if the Licensee cannot so certify.

FCC Form 608 – Schedule A Instructions

(Edition Date) - Page 2

Installment Payment Plan – (Long-Term De Facto Transfer Only)

Eligibility Status

Item 7 This item must be completed for each Application/Notification for a Long-Term De Facto Transfer Lease/Sublease. Check the appropriate response.


If the Lessee/Sublessee/Transferee qualifies for the same eligibility status for the installment payment plan as the current Licensee, or qualifies for a more favorable installment payment plan than the current Licensee, it should so indicate by checking the first box. If the Lessee/Sublessee/Transferee qualifies for an installment payment plan, but does not qualify for as favorable an installment payment plan as the Licensee, the Lessee/Sublessee/Transferee should respond by checking the second box. If the Lessee/Sublessee/Transferee checks either the second box or if it does not qualify for any installment payment plan (and thus checks the third box), an unjust enrichment payment WILL be required. Secondary Markets Order, 18 FCC Rcd. at 20666-67 ¶ 145. Refer to the appropriate FCC competitive bidding rules, and to the service-specific rules in 47 CFR. If the Lessee/Sublessee/Transferee qualifies for an installment payment plan, it must complete Items 11-39 and attach an exhibit in accordance with 47 CFR disclosing the Lessee/Sublessee/Transferee’s eligibility for an installment payment plan.


Closed Bidding Licenses

Items 8-10 require information from Licensees and Lessees/Sublessees/Transferees in those instances in which the Lease/Sublease involves spectrum associated with license(s) for which the Licensee obtained a closed bidding license. See 47 CFR §§ 1.2110-1.2112, 24.709 (rules pertaining to licensees that participate in the closed bidding program); §§ 19020(d)(4), 1.9030(d)(4) (rules pertaining to leasing involving licensees in the closed bidding program); and appropriate FCC competitive bidding rules and applicable service rules in Title 47 of the Code of Federal Regulations (47 CFR).


Items 8 Enter ‘Y’ if construction notifications have been submitted for each of the subject licenses. Otherwise, enter ‘N’. If the response to Item 8 is ‘Y’, Items 9 and 10 are not required to be completed. If the response to Item 8 is ‘N’, complete Item 9 or 10, as appropriate.


Closed Bidding Licenses – (Spectrum Manager Only)

Item 9 Must be completed for each Application/Notification for a Spectrum Manager Lease/Sublease in which the license(s) associated with the spectrum was obtained in the Commission’s closed bidding program. In general, for purposes of determining whether a licensee retains its eligibility for a license obtained in closed bidding, the gross revenues of the licensee, its “controlling interest(s),” and any “affiliate(s)” of the licensee or of any “controlling interest” are considered on a cumulative basis and aggregated. See 47 CFR §§ 1.2110(b), 1.2112(b), 24.709. A “controlling interest” includes any individual or entity with either de jure or de facto control of the licensee. See § 1.2110(c)(2). An “affiliate” includes any individual or entity holding an attributable interest in the licensee as set forth in § 1.2110(c)(5). Note that the Commission’s attribution rules relating to “controlling interest(s)” (and the standard for determining de facto control embodied therein) and “affiliate(s),” as set forth in § 1.2110, are not altered by the different de facto control standard generally applicable to spectrum leasing arrangements, as set forth in § 1.9010 of the Commission’s Rules. See Secondary Markets Order, 18 FCC Rcd. 20604. To the extent that there is any conflict between section 1.2110 (and the de facto control standard embodied therein) and the de facto control standard in Section 1.9010, the provisions of § 1.2110 govern with regard to whether a licensee has maintained the requisite degree of ownership and control to allow it to remain eligible for the license or for other benefits such as bidding credits and installment payments. See Secondary Markets Order, 18 FCC Rcd. at 20654-55 ¶ 113.


Item 9a Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) has a general partnership interest or has direct or indirect ownership interests in excess of ten percent in the Licensee. Otherwise, enter ‘N’.


Item 9b Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) is a “controlling interest holder” or “affiliate” of the current Licensee. Otherwise, enter ‘N’.


Item 9c Enter ‘Y’ if the Applicant (Lessee/Sublessee/Transferee) shares office space, equipment or other facilities with any party controlling the entity from which spectrum is being leased/subleased. Otherwise, enter ‘N’.


Item 9d Enter ‘Y’ if the Licensee can certify that the Lease/Sublease does not affect its continuing eligibility to retain closed bidding licenses. Enter ‘N’ if the Licensee cannot so certify.


Closed Bidding Licenses – (Long-Term De Facto Transfer Only)

Eligibility Status

Item 10 This item must be completed for each Application/Notification for a Long-Term De Facto Transfer Lease/Sublease. Check the appropriate response.



FCC Form 608 – Schedule A Instructions

(Edition Date) - Page 3


If the Lessee/Sublessee/Transferee meets the gross revenue and asset qualifications for closed bidding/entrepreneurial licenses, see 47 C.F.R. § 24.709(a), it should so indicate by checking the first box. If the Lessee/Sublessee/Transferee does not meet the gross revenue and asset qualifications for closed bidding/entrepreneurial licenses, it should so indicate by checking the second box. If the Lessee/Sublessee/Transferee checks the second box, the Licensee/Lessee/Sublessee/Transferee will not be allowed to enter into a Lease/Sublease, unless the parties comply with one of the exemptions under Section 24.839(a) of the Commission’s rules. 47 C.F.R. §24.839(a). See Secondary Markets Order, 18 FCC Rcd. at 20666-67 ¶ 145. If the Lessee/Sublessee/Transferee qualifies for closed bidding/entrepreneurial licenses, it must complete Items 11-39.


Revenue and Asset Information for Applicant

Item 11 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 12a 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 12b and 12c. 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 13a 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 13b and 13c. 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 14a 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 14b and 14c. 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 15 The Universal Licensing System will calculate the average gross revenue for the reported years in Items 12, 13 and 14.


Asset Disclosure

Item 16 Enter the total assets disclosed as of the application filing date.


Financial Statements

Item 17 Check if the Applicant used audited financial statements or unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by the Applicant’s chief financial officer or the equivalent.


Revenue and Asset Information for Disclosable Interest Holder (DIH)

Item 18 Select the proper block to Add, Modify, or Delete a DIH. If Adding, complete items 19 through 25. 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 previously filed application. If necessary, attach additional copies of this page to list more DIHs.


Disclosable Interest Holder

Item 19 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 20a 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 20b and 20c. 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 21a 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 21b and 21c. 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.




FCC Form 608 – Schedule A Instructions

(Edition Date) - Page 4


Two Years Prior to Most Recent Reportable Year

Item 22a 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 22b and 22c. 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 23 The Universal Licensing System will calculate the average gross revenue for the reported years provided in Items 20, 21, and 22.


Asset Disclosure

Item 24 Enter the total assets disclosed as of the application filing date.


Financial Statements

Item 25a Check if the DIH used audited financial statements or unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by the DIH’s chief financial officer or the equivalent.


Revenue and Asset Information for Affiliate

Item 26 Select the proper block to Add, Modify, or Delete an Affiliate. If Adding, complete items 27 through 33. 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 previously filed application. If necessary, attach additional copies of this page to list more Affiliates.


Affiliate

Item 27 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 28a 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 28b and 28c. 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 29a 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 29b and 29c. 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 30a 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 30b and 30c. 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 31 The Universal Licensing System will calculate the average gross revenue for the reported years provided in Items 28, 19 and 30.


Asset Disclosure

Item 32 Enter the total assets disclosed as of the application filing date.


Financial Statements

Item 33 Check if the Affiliate used audited financial statements or unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by the Affiliate’s chief financial officer or the equivalent.


Revenue and Asset Information for Entities With Whom the Applicant Has an Attributable Material Relationship (AMR Entity)

Item 34 Select the proper block to Add, Modify, or Delete an AMR Entity. If Adding, complete items 35 through 41. If Modifying, enter only the items changed. If Deleting, complete the Entity Name or the Individual Name and the FRN of the AMR Entity. Modify and Delete are used for Amendments of previously filed application. If necessary, attach additional copies of this page to list more AMR Entities.



FCC Form 608 – Schedule A Instructions

(Edition Date) - Page 5


Entity With Whom the Applicant Has an Attributable Material Relationship

Item 35 Select the proper block for either Entity Name or Individual name of the AMR Entity and provide Entity Name or Individual name and the FCC Registration Number (FRN) of the AMR Entity.


Gross Revenue Disclosure

Most Recent Reportable Year

Item 36a Enter ‘Y’ if the AMR Entity and any predecessors-in-interest were in existence and had gross revenues for the most recent reportable year. If ‘Y’, complete items 36b and 36c. Enter ‘N’ if the AMR Entity 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 37a Enter ‘Y’ if the AMR Entity 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 37b and 37c. Enter ‘N’ if the AMR Entity 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 38a Enter ‘Y’ if the AMR Entity 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 38b and 38c. Enter ‘N’ if the AMR Entity 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 39 The Universal Licensing System will calculate the average gross revenue for the reported years provided in Items 36, 37 and 38.


Asset Disclosure

Item 40 Enter the total assets disclosed as of the application filing date.


Financial Statements

Item 41 Check if the AMR Entity used audited financial statements or unaudited statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by the AMR Entity’s chief financial officer or the equivalent.


Closed Bidding /Designated Entity Eligibility

Total Gross Revenues for Most Recent Reportable Year

Item 42 The Universal Licensing System will calculate the total gross revenue for the most recent reportable year and the year end date.


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

Item 43 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 Gross Revenues for Two Years Prior to Most Recent Reportable Year

Item 44 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 45 The Universal Licensing System will calculate the aggregate average gross revenue for the designated entity.


Total Aggregate Average Gross Revenues for Closed Bidding

Item 46 The Universal Licensing System will calculate the aggregate average gross revenue for the closed bidding.


Total Assets Disclosure

Item 47 The Universal Licensing System will calculate the total assets for the closed bidding.


Certifications

By signing the Main Form, FCC Form 608, the Licensee and Lessee/Sublessee/Transferee certify that the applicable statements listed in this section are true, complete, correct, and made in good faith.




FCC Form 608 – Schedule A Instructions

(Edition Date) - Page 6

FCC Form 608 Federal Communications Commission Approved by OMB

Schedule A 3060 - 1058

See 608 Main Form Instructions

for public burden estimate

Schedule for Licensees that Received Bidding Credits or

Participate in the Installment Payment Plan, or

Involving Licenses Won in Closed Bidding


Designated Entity Information

Bidding Credits

1) Has the full amount of the 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’, Items 2 and 3 are not required to be completed.

( ) Yes No



Bidding Credits - (Spectrum Manager Only)

2a) Does the Applicant have a general partnership interest or have a direct or indirect ownership interests in

excess of ten percent in the Licensee?


( ) Yes No

2b) Is the Applicant a “controlling interest holder” or “affiliate” of the current Licensee?

( ) Yes No

2c) Does the Applicant share office space, equipment or other facilities with any party controlling the entity from which spectrum is being leased/subleased?


( ) Yes No

2d) Does the Licensee certify that the Lease/Sublease does not affect its continuing eligibility to retain bidding credit(s)?

( ) Yes No


Bidding Credits – (Long-Term De Facto Transfer Only)

Eligibility Status

3) 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 Payment Plan

4) Have all the installment payment obligations for each of the subject licenses been paid in full?

If the response to Item 4 is ‘Y’, Items 5, 6 and 7 are not required to be completed..

( ) Yes No


5a) Have both the Licensee and the Applicant executed the Commission-approved financing documents required in order to enter into a Spectrum Leasing Arrangement?

If ‘Y’, provide the dates of execution of the financing documents:

( ) Yes No


5b) Modification of Security Agreement Date: (MM/DD/YYYY)



_______/_______/________

5c) Lien Acknowledgment Date: (MM/DD/YYYY)


_______/_______/________


Installment Payment Plan - (Spectrum Manager Leases/Subleases Only)

6a) Does the Applicant have a general partnership interest or have a direct or indirect ownership interest in

excess of ten percent in the Licensee?

( ) Yes No

6b) Is the Applicant a “controlling interest holder” or “affiliate” of the current Licensee?

( ) Yes No

6c) Does the Applicant share office space, equipment or other facilities with any party controlling the entity from which spectrum is being leased?

( ) Yes No

6d) Does the Licensee certify that the Lease/Sublease does not affect its continuing eligibility to participate in the FCC’s installment payment plan?

( ) Yes No


FCC Form 608 – Schedule A

(Edition Date) - Page 1

Installment Payment Plan – (Long-Term De Facto Transfer Only)

Eligibility Status

7) 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

8) Have construction notifications been submitted as required by the Commission’s Rules for each of the subject licenses?


If the response to Item 8 is ‘Y’, Items 9 and 10 are not required to be completed.


( ) Yes No



Closed Bidding Licenses – (Spectrum Manager Only)

9a) Does the Applicant have a general partnership interest or have a direct or indirect ownership interest in excess of ten percent in the Licensee?

( ) Yes No

9b) Is the Applicant a “controlling interest holder” or “affiliate” of the current Licensee?

( ) Yes No

9c) Does the Applicant share office space, equipment or other facilities with any party controlling the entity

from which spectrum is being leased?


( ) Yes No

9d) Does the Licensee certify that the Lease/Sublease does not affect its continuing eligibility to retain closed bidding licenses?

( ) Yes No


Closed Bidding Licenses(Long-Term De Facto Transfer Only)

Eligibility Status

10) With respect to each of the subject licenses, the Applicant:

( ) a) qualifies for closed bidding

( ) b) does not qualify for closed bidding





























FCC Form 608 – Schedule A

(Edition Date) - Page 2

11) 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


12a) 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.


12b) Gross Revenues $_____________________ (Format: 99,999.99)


12c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



One Year Prior to Most Recent Reportable Year


13a) 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.


13b) Gross Revenues $_____________________ (Format: 99,999.99)


13c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Two Years Prior to Most Recent Reportable Year


14a) 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.

14b) Gross Revenues $_____________________ (Format: 99,999.99)


14c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Average Gross Revenue


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



Asset Disclosure


16) Total Assets as of Application Filing Date: $_____________________________



Financial Statements


17) 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.




FCC Form 608 – Schedule A

(Edition Date) - Page 3

18) Revenue and Asset Information for Disclosable Interest Holder (DIH)

Purpose (Select One)

Add Modify Delete


19) 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

20a) 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.

20b) Gross Revenues $_____________________ (Format: 99,999.99)


20c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



One Year Prior to Most Recent Reportable Year

21a) 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.

21b) Gross Revenues $_____________________ (Format: 99,999.99)


21c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Two Years Prior to Most Recent Reportable Year

22a) 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.

22b) Gross Revenues $_____________________ (Format: 99,999.99)


22c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Average Gross Revenue


23) Average Gross Revenue for Reported Years: $_____________________________ (Format: 99,999.99)



Asset Disclosure


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



Financial Statements


25) 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.


FCC Form 608 – Schedule A

(Edition Date) - Page 4


26) Revenue and Asset Information for Affiliate

Purpose (Select One)


Add Modify Delete



27) Affiliate

Entity Name:


FCC Registration Number (FRN):

Individual Name: First


MI

Last

Suffix

FCC Registration Number (FRN):


Gross Revenue Disclosure Most Recent Reportable Year

28a) 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.


28b) Gross Revenues $_____________________ (Format: 99,999.99)


28c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



One Year Prior to Most Recent Reportable Year

29a) 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.

29b) Gross Revenues $_____________________ (Format: 99,999.99)


29c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Two Years Prior to Most Recent Reportable Year

30a) 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.

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


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



Average Gross Revenue


31) Average Gross Revenue for Reported Years: $_____________________________ (Format: 99,999.99)



Asset Disclosure


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



Financial Statements


33) 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.

FCC Form 608 – Schedule A

(Edition Date) - Page 5

34) Revenue and Asset Information for Entities With Whom the Applicant Has an Attributable Material Relationship (AMR Entity)

Purpose (Select One)


Add Modify Delete




35) Entity With Whom the Applicant Has an Attributable Material Relationship

Entity Name:


FCC Registration Number (FRN):

Individual Name: First


MI

Last

Suffix

FCC Registration Number (FRN):


Gross Revenue Disclosure Most Recent Reportable Year

36a) Were the AMR Entity 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.


36b) Gross Revenues $_____________________ (Format: 99,999.99)


36c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



One Year Prior to Most Recent Reportable Year

37a) Were the AMR Entity 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.

37b) Gross Revenues $_____________________ (Format: 99,999.99)


37c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Two Years Prior to Most Recent Reportable Year

38a) Were the AMR Entity 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.

38b) Gross Revenues $_____________________ (Format: 99,999.99)


38c) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Average Gross Revenue


39) Average Gross Revenue for Reported Years: $_____________________________ (Format: 99,999.99)



Asset Disclosure


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



Financial Statements


41) Audited or Unaudited (Check One)


The AMR Entity used audited financial statements.


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

FCC Form 608 – Schedule A

(Edition Date) - Page 6

Closed Bidding/Designated Entity Eligibility

Total Gross Revenues for Most Recent Reportable Year

42a) Gross Revenues $_____________________ (Format: 99,999.99)


42b) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



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

43a) Gross Revenues: $_____________________ (Format: 99,999.99)


43b) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



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

44a) Gross Revenues: $_____________________ (Format: 99,999.99)


44b) Year End Date: _____________________ (Date Format: MM/DD/YYYY)



Total Aggregate Average Gross Revenues for Designated Entity


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



Total Aggregate Average Gross Revenues for Closed Bidding


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



Total Assets Disclosure for Closed Bidding


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




























FCC Form 608 – Schedule A

(Edition Date) - Page 7

Certifications (By signing the Main Form, the Applicant certifies that the statements listed are true, complete, correct and made in good faith)


For Applicants Claiming Eligibility as an Entrepreneur Under the General Rule

Applicant certifies that it is eligible to obtain the licenses for which it applies.


For Applicants Claiming Eligibility as a Publicly Traded Corporation

Applicant certifies that it is eligible to obtain the licenses for which it applies and that it complies with the definition of a Publicly Traded Corporation, as set out in the applicable FCC rules.


For Applicants Claiming Eligibility as a Very Small Business, Very Small Business Consortium, Small Business, or Small Business Consortium

Applicant certifies that it is eligible for the bidding credit it seeks in connection with the licenses for which it is applying.


For Applicants Claiming Eligibility as a Rural Telephone Company

Applicant certifies that it meets the definition of a Rural Telephone Company as set out in the applicable FCC rules, and must disclose all parties to agreement(s) to partition licenses won in this auction. See applicable FCC rules.


For Applicants Claiming Tribal Lands Bidding Credit

Applicant certifies that it will comply with the bidding credit buildout requirements and consult with the tribal government(s) regarding the siting of facilities and deployment of service on the tribal land(s) as set out in the applicable FCC rules.


For Auction Applicants

Applicant provided separate gross revenue information for itself, for each of Applicant's officers and directors; for each of Applicant's other controlling interests; for each of Applicant's affiliates; and for each affiliate of each of Applicant's officers, directors, and other controlling interests.

Applicant provided separate gross revenue and total asset information for itself, for each of Applicant's officers and directors; for each of Applicant's other controlling interest; for each of Applicant’s affiliates; and for each affiliate of each Applicant's officers, directors, and other controlling interests.























FCC Form 608 – Schedule A

(Edition Date) - Page 8



File Typeapplication/msword
File TitleFCC 603-T
Authorbedwards
Last Modified ByJudith-B.Herman
File Modified2010-12-03
File Created2010-12-03

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