Form FCC Form 350 FCC Form 350 Application for an FM Translator or FM Booster Station L

Federal Communications Commission
Washington, D.C. 20554

Approved by OMB
3060-0404

APPLICATION FOR AN FM TRANSLATOR
OR FM BOOSTER STATION LICENSE
GENERAL INSTRUCTIONS
A. When to Use this Form. This FCC Form is to be used in
all cases when applying for an FM translator or FM booster
broadcast station license. The form consists of the
following sections:
I. General Information
II. Legal Qualifications
III. Preparer's Certification (for preparer of engineering
sections of the application) and Engineering Data

D. Paper Filing of Application Forms. Applicants that
prepare this application in paper form should file an
original and two copies of this application and all exhibits.
Applicants should follow the procedures set forth in Part 0
and Part 74 of the Commission's Rules. Amendments to
previously filed applications should be prepared and
submitted in original and two copies, signed in the same
manner as the original application, and should contain the
following information to identify the associated application:
(1)
(2)
(3)
(4)
(5)

B. FCC Rules. This application form makes many references
to FCC rules. Applicants should have on hand and be
familiar with current broadcast rules in Title 47 of the Code
of Federal Regulations (C.F.R.):

(6)
(1) Part 0
(2) Part 1
(3) Part 73
(4) Part 74

"Commission Organization"
"Practice and Procedure"
"Radio Broadcast Services"
"Experimental, Auxiliary, and Special
Broadcast and Other Program Distributional
Services"

FCC Rules may be purchased from the Government
Printing Office. Current prices may be obtained from the
GPO Customer Service Desk at (202) 512-1803. For
payment by credit card, call (202) 512-1800, M-F, 8 a.m. to
4 p.m. e.s.t; facsimile orders may be placed by dialing (202)
518-2233, 24 hours a day. Payment by check may be made
to the Superintendent of Documents, Attn: New Orders,
P.O. Box 371954, Pittsburgh, PA 15250-7954.
C. Electronic Filing of Application Forms.
The
Commission is currently developing electronic versions of
various broadcast station application and reporting forms,
such as this application form. As each application form and
report goes online, the Commission will by Public Notice
announce its availability and the procedures to be followed
for accessing and filing the application form or report
electronically via the Internet. For a six-month period
following the issuance of the Public Notice, the subject
application form or report can be filed with the
Commission either electronically or in a paper format.
Electronic filing will become mandatory, on a form-byform basis, six months after each application form or report
becomes available for filing electronically.

All previous editions obsolete.

(7)

Applicant's name.
Call letters or specify "NEW" station.
Channel number.
Community of license.
File number of application being amended (if
known).
Date of filing of application being amended (if file
number is not known).
Facility ID Number.

E. Public Inspection File. A copy of the completed
application and all related documents shall be made
available for inspection by the public. The station records
should be maintained at an accessible location in one of the
communities of license of the translator or booster, except
that the station records of a translator or booster owned by
the licensee of the primary station rebroadcast may be kept
at the same place where the primary station's records are
kept. See 47 C.F.R. Sections 74.1281, 73.1125.
F.

Defective Applications. Applicants should provide all
information requested by this application. No section may
be omitted. Responses indicating “on file” are not
acceptable. If any portions of the application are not
applicable, the applicant should so state. Defective or
incomplete applications will be returned without
consideration.
Inadvertently accepted applications are
also subject to dismissal.

G. Current Information. In accordance with 47 C.F.R.
Section 1.65, applicants have a continuing obligation to
advise the Commission, through amendments, of any
substantial and material changes in the information
furnished in this application. This requirement continues
until the FCC action on this application is no longer subject
to reconsideration by the Commission or review by any
court.

FCC 350 Instructions
April 2001

The name of the applicant must be stated exactly in Item 1.
If the applicant is a corporation, the applicant should list
the exact corporate name; if a partnership, the name under
which the partnership does business; if an unincorporated
association, the name of an executive officer, his/her office,
and the name of the association; and, if an individual
applicant, the person's full legal name.

H. Worksheets and Certifications. This application requires
applicants to certify compliance with many statutory and
regulatory requirements. Detailed instructions provide
additional information regarding Commission rules and
policies. These materials are designed to track the
standards and criteria which the Commission applies to
determine compliance and to increase the reliability of
applicant certifications. They are not intended to be a
substitute for familiarity with the Communications Act and
the Commission's regulations, policies, and precedent.
While applicants are required to review all application
instructions, they are not required to complete or retain any
documentation created or collected to complete the
application.
I.

J.

FCC Registration Number (FRN). To comply with the
Debt Collection Improvement Act of 1996, the applicant
must enter its FRN number, a ten-digit unique entity
identifier for anyone doing business with the
Commission. The FRN can be obtained through the FCC
webpage at http://www.fcc.gov or by manually
submitting FCC Form 160. FCC Form 160 is available
for downloading from http://www.fcc.gov/formpage.
html or by calling 1-800-418-3676.
Questions
concerning the FCC Registration Number can be directed
to the Commission’s Registration System help desk at
1-877http://[email protected] or by calling
480-3201.

Exhibits. This application is presented primarily in a
"Yes/No" certification format. However, it contains places
for submitting explanations and exhibits where necessary or
appropriate. Each certification constitutes a material
representation. Applicants may only mark the "Yes"
certification when they are certain that the response is
correct. A "No" response is required if the applicant is
requesting a waiver of a pertinent rule and/or policy, or
where the applicant is uncertain that the application fully
satisfies the pertinent rule and/or policy. Thus, a "No"
response to a certification item will not cause the
immediate dismissal of the application if this form provides
an “Exhibit Box” for the item, indicating that filing an
exhibit is acceptable, and if an appropriate exhibit is
submitted.

Facility ID Number. Radio and TV Facility ID Numbers
can be obtained at the FCC's Internet Website at
www.fcc.gov/mmb. Once at this website, scroll down and
select CDBS Public Access. You can also obtain your
facility ID number by calling: Radio (202) 418-2700, TV
(202) 418-1600. Further, the Facility ID Number is now
included on all Radio and TV authorizations and postcards.
B. Item 2: Contact Representative. If the applicant is
represented by a third party (for example, legal counsel),
that person's name, firm or company, and
telephone/electronic mail address may be specified in Item
2.

Signatures.
The applicant, or the applicant's
authorized representative, must sign the application.
Depending on the nature of the applicant, the application
should be signed as follows: if a sole proprietorship,
personally; if a partnership, by a general partner; if a
corporation, by an officer; for an unincorporated
association, by a member who is an officer; if a
governmental entity, by such duly elected or appointed
official as is competent under the laws of the particular
jurisdiction. Counsel may sign the application for his or
her client, but only in cases of the applicant's disability or
absence from the United States. If the application is filed
electronically, the signature will consist of the electronic
equivalent of the typed name of the individual. See Report
and Order in MM Docket No. 98-43, 13 FCC Rcd 23,056,
23,064 (1998).

INSTRUCTIONS
INFORMATION

FOR

SECTION

I:

C. Item 3: Fees. The Commission is statutorily required to
collect charges for certain regulatory services to the public.
Generally, applicants seeking authority to construct a new
broadcast station or modify an outstanding authorization
are required to submit a fee with the filing of FCC Form
350. Government entities, however, are exempt from this
fee requirement. Exempt entities include possessions,
states, cities, counties, towns, villages, municipal
organizations, and political organizations or subparts
thereof governed by elected or appointed officials
exercising sovereign direction over communities or
governmental programs. Also exempt are full-service
noncommercial educational radio and TV broadcast
licensees and permittees, provided that the proposed
facility will be operated noncommercially. See 47 C.F.R.
Section 1.1114.

GENERAL

A. Item 1: Applicant Name. Applicants should use only
those state abbreviations approved by the U.S. Postal
Service.

When filing a fee-exempt application, an applicant must
complete Item 3 and provide an explanation as appropriate.
Applications NOT subject to a fee may be hand-delivered

2

For further information regarding the applicability of a fee,
the amount of the fee, or the payment of the fee, applicants
should consult the "Mass Media Services Fee Filing
Guide."

or mailed to the FCC at its Washington, D.C. offices. See
47 C.F.R. Section 0.401(a). Fee-exempt applications
should not be sent to the Mellon Bank Lockbox; so doing
will result in a delay in processing the application.
The Commission's fee collection program utilizes a U.S.
Treasury lockbox bank for maximum efficiency of
collection and processing. Prior to the institution of
electronic filing procedures, all FCC Form 350 applications
requiring the remittance of a fee, or for which a waiver or
deferral from the fee requirement is requested, must be
submitted to the appropriate post office box address. See
47 C.F.R. Section 0.401(b). A listing of the required fee
and the address to which FCC Form 350 should be mailed
or otherwise delivered are also set forth in the "Mass Media
Services Fee Filing Guide." This document can be
obtained either by writing to the Commission's Form
Distribution Center, 9300 E. Hampton Drive, Capital
Heights, Maryland 20743, or by calling 1-800-418-FORM
and leaving a request on the answering machine provided
for this purpose. See also 47 C.F.R. Section 1.1104. The
Fee Filing Guide also contains a list of the Fee Type Codes
needed to complete this application.

INSTRUCTIONS
INFORMATION

FOR

SECTION

II:

LEGAL

A. Item 1: Certification. Each applicant is responsible for
the information that the application instructions convey. As
a key element in the Commission's streamlined licensing
process, a certification that these materials have been
reviewed and that each question response is based on the
applicant's review is required.
B. Item 2: Permit Conditions. This question requires the
applicant to certify that all terms, conditions, and
obligations set forth in the underlying construction permit
have been fully met. Each Applicant should review its
underlying construction permit carefully prior to making its
certification to confirm that the facility was constructed
exactly in accordance with the permit. If any such term,
condition, or obligation has not been fulfilled, the applicant
should respond "No" to Section II, Item 2 and provide an
appropriate explanatory exhibit. See 47 C.F.R. Section
74.1251.

Payment of any required fee must be made by check, bank
draft, money order, or credit card. If payment is made by
check, bank draft, or money order, the remittance must be
denominated in U.S. dollars, drawn upon a U.S. institution,
and made payable to the Federal Communications
Commission. No postdated, altered, or third-party checks
will be accepted. DO NOT SEND CASH. Additionally,
checks dated six months or older will not be accepted.

C. Item 3: Changed Circumstances. This question requires
the applicant to certify that all information provided in the
underlying construction permit application remains correct.
If any circumstance has arisen which would cause any
statement or representation contained in the construction
permit application to be incorrect, the applicant should
respond "No" to Section II, Item 3 and provide an
appropriate explanatory exhibit.

Procedures for payment of application fees when
applications are filed electronically can be found by
clicking on the CDBS link to the Electronic Filing
introductory page on the Mass Media Bureau’s Home Page
Website at www.fcc.gov/mmb.

D. Item 4: Programming. An FM translator operator
proposing to rebroadcast the signal of a primary station
which it does not own must obtain written permission of
that station prior to retransmission of that signal. See 47
C.F.R. Section 74.1284. Section II, Item 4 requires the
applicant to certify that such written authority has been
received.
FM translator applicants proposing to
rebroadcast the signal of stations that they own, as well as
applicants for FM booster stations, should mark the box
labelled "Yes."

Payment of application fees may also be made by
Electronic Payment prior to the institution of electronic
filing, provided that prior approval has been obtained from
the Commission. Applicants interested in this option must
first contact the Billings and Collections Branch at (202)
418-1995 to make the necessary arrangements.
Applicants hand-delivering FCC Forms 350 may receive
dated receipt copies by presenting copies of the applications
to the acceptance clerk at the time of delivery. For mailedin applications, a "return copy" of the application should be
furnished and clearly marked as a "return copy." The
applicant should attach this copy to a stamped, selfaddressed envelope.
Only one piece of paper per
application will be stamped for receipt purposes.

E. Item 5: Station Ready for Operation. This question
requires the applicant to certify that the authorized facility
is in satisfactory operating condition and ready for regular
operation. See 47 C.F.R Section 73.3598(e). Partially
constructed facilities, or facilities that are less than
authorized in the underlying construction permit, are not
sufficient.

3

F.

adverse finding that has not been reported to the
Commission and considered in connection with a prior
application would require a "No" response.

Item 6: Station Identification. FM translator stations are
required to broadcast station identification announcements.
This can be done in one of two ways. First, the translator
station can arrange with the primary station whose signal is
rebroadcast to identify the translator station by call sign and
location.

Where the response to Item 8 is "No," the applicant must
provide in an exhibit a full disclosure of the persons and
matters involved, including an identification of the court or
administrative body and the proceeding (by dates and file
numbers), and the disposition of the litigation. Where the
requisite information has been earlier disclosed in
connection with another pending application, or as required
by 47 U.S.C. Section 1.65(c), the applicant need only
provide an identification of that previous submission by
reference to the file number in the case of an application,
the call letters of the station regarding which the application
or Section 1.65 information was filed, and the date of filing.
The applicant should also fully explain why the adverse
finding is not an impediment to a grant of this application.

If the translator station utilizes this method of station
identification, there must be three announcements each
day: one between 7 a.m. and 9 a.m., one between 12:55
p.m. and 1:05 p.m., and one between 4 p.m. and 6 p.m.
FM translator stations that do not begin broadcasting before
9 a.m. must make their first announcement at the beginning
of their broadcast day.
Alternatively, the FM translator may transmit its call sign in
International Morse Code at least once each hour. See 47
C.F.R. Sections 74.1283 and 73.1201.

NOTE: As used in this question, the term "party to the
application" includes any individual or entity whose
ownership or positional interest in the applicant is
attributable. An attributable interest is an ownership
interest in or relation to an applicant or licensee which will
confer on its holder that degree of influence or control over
the applicant or licensee sufficient to implicate the
Commission's multiple ownership rules. See 47 C.F.R.
Section 73.3555, as revised and explained in Review of the
Commission's Regulations Governing Attribution of
Broadcast and Cable/MDS Interests, FCC 99-207, released
August 6, 1999. See also, Report and Order in MM
Docket No. 83-46, 97 FCC 2d 997 (1984), reconsideration
granted in part, 58 RR 2d 604 (1985), further modified on
reconsideration, 61 RR 2d 739 (1986). General guidelines
are set forth below.

G. Items 7 and 8: Character Issues/Adverse Findings. Item
7 requires the applicant to certify that neither it nor any
party to the application has had any interest in or
connection with an application that was or is the subject of
unresolved character issues. An applicant must disclose in
response to Item 8 whether the applicant or any party to the
application has been the subject of a final adverse finding
with respect to certain relevant non-broadcast matters. The
Commission's character policies and litigation reporting
requirements for broadcast applicants focus on misconduct
which violates the Communications Act or a Commission
rule or policy and on certain specified non-FCC
misconduct. In responding to Items 7 and 8, applicants
should review the Commission's character qualifications
policies, which are fully set forth in Character
Qualifications, 102 FCC 2d 1179 (1985), reconsideration
denied, 1 FCC Rcd 421 (1986), as modified, 5 FCC Rcd
3252 (1990) and 7 FCC Rcd 6564 (1992).

INVESTORS AND CREDITORS: Certain interests held
by substantial investors in, or creditors of, the applicant
may be attributable and the investor reportable as a party to
the application, if the interest falls within the Commission's
equity/debt plus (EDP) attribution standard. Under the
EDP standard, the interest held, aggregating both equity
and debt, must exceed 33% of the total asset value (all
equity plus all debt) of the applicant, a broadcast station
licensee, cable television system, daily newspaper or other
media outlet subject to the Commission's broadcast multiple
ownership rules AND the interest holder must either also
hold an attributable interest in a media outlet in the same
market or supply over 15% of the total weekly broadcast
programming hours of the station in which the interest is
held. For example, the equity interest of an insulated
limited partner in a limited partnership applicant would
normally not be considered attributable. However, under
the EDP standard, that interest would be attributable if the
limited partner's interest exceeded 33% of the applicant's
total asset value AND the limited partner also held a 5%

Where the response to Item 7 is "No," the applicant must
submit an exhibit that includes an identification of the party
having had the interest, the call letters and location of the
station or file number of the application or docket, and a
description of the nature of the interest or connection,
including relevant dates. The applicant should also fully
explain why the unresolved character issue is not an
impediment to a grant of this application.
In responding to Item 8, the applicant should consider any
relevant adverse finding that occurred within the past ten
years. Where that adverse finding was fully disclosed to
the Commission in an application filed on behalf of this
station or in another broadcast station application and the
Commission, by specific ruling or by subsequent grant of
the application, found the adverse finding not to be
disqualifying, it need not be reported again and the
applicant may respond "Yes" to this item. However, an

4

INDIVIDUAL APPLICANT: The natural person seeking
to hold in his or her own right the authorization specified in
this application is a party to the application.

Notwithstanding conformance of the partnership agreement
to these criteria, however, if the applicant has actual
knowledge of a material involvement of a limited partner in
the management or operation of the media-related
businesses of the partnership, the limited partner will be
considered as a party to this application.

PARTNERSHIP APPLICANT: Each partner, including
all limited partners may be parties to the application.
However, a limited partner in a limited partnership is not
considered a party to the application IF the limited partner
is not materially involved, directly or indirectly, in the
management or operation of the media-related activities of
the partnership. Sufficient insulation of a limited partner
for purposes of this certification would be assured if the
limited partnership arrangement:

LIMITED LIABILITY COMPANY APPLICANT: The
Commission treats a LLC as a limited partnership, each of
whose members is considered to be a party to the
application. However, where a LLC member is insulated in
the manner specified above with respect to a limited
partnership and where the relevant state statute authorizing
the LLC permits a LLC member to insulate itself in
accordance with the Commission's criteria, that LLC
member is not considered a party to the application.

(1)

specifies that any exempt limited partner (if not a
natural person, its directors, officers, partners, etc.)
cannot act as an employee of the limited partnership
if his or her functions, directly or indirectly, relate to
the media enterprises of the company;

(2)

bars any exempt limited partner from serving, in any
material capacity, as an independent contractor or
agent with respect to the partnership's media
enterprises;

(3)

restricts any exempted limited partner from
communicating with the licensee or the general
partner on matters pertaining to the day-to-day
operations of its business;

(4)

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

(5)

prohibits any exempt limited partner from voting on
the removal of a general partner or limits this right to
situations where the general partner is subject to
bankruptcy proceedings, as described in Sections
402 (4)-(5) of the Revised Uniform Limited
Partnership Act, is adjudicated incompetent by a
court of competent jurisdiction, or is removed for
cause, as determined by an independent party;

(6)

bars any exempt limited partner from performing
any services to the limited partnership materially
relating to its media activities, with the exception of
making loans to, or acting as a surety for, the
business; and

CORPORATE APPLICANT: Each officer, director and
owner of stock accounting for 5% or more of the issued and
outstanding voting stock of the applicant is considered a
party to the application. Where the 5% stock owner is itself
a corporation, each of its stockholders, directors and
"executive" officers (president, vice-president, secretary,
treasurer or their equivalents) is considered a party to this
application UNLESS the applicant submits as an exhibit a
statement establishing that an individual director or officer
will not exercise authority or influence in areas that will
affect the applicant or the station. In this statement, the
applicant should identify the individual by name and title,
describe the individual's duties and responsibilities, and
explain the manner in which such individual is insulated
from the corporate applicant and should not be attributed an
interest in the corporate applicant or considered a party to
this application. In addition, a person or entity holding an
ownership interest in the corporate stockholder of the
applicant is considered a party to this application ONLY IF
that interest, when multiplied by the corporate stockholder's
interest in the applicant, would account for 5% or more of
the issued and outstanding voting stock of the applicant.
For example, where Corporation X owns stock accounting
for 25% of the applicant's votes, only Corporation X
shareholders holding 20 percent or more of the issued and
outstanding voting stock of Corporation X have a 5% or
more indirect interest in the applicant (.25 x .20 = .05) and,
therefore, are considered parties to this application. In
applying the multiplier, any entity holding more than 50%
of its subsidiary will be considered a 100% owner. Where
the 5% stock owner is a partnership, each general partner
and any limited partner that is not insulated, regardless of
the partnership interest, is considered a party to the
application.

(7)

states, in express terms, that any exempt limited
partner is prohibited from becoming actively
involved in the management or operation of the
media businesses of the partnership.

Stock subject to stockholder cooperative voting agreements
accounting for 5% or more of the votes in a corporate
applicant will be treated as if held by a single entity and any
stockholder holding 5% or more of the stock in that block is

voting interest in a radio or television station licensee in the
same market.

5

completed if the engineering portion of the application has
been prepared by the applicant. In that event, the
applicant's certification on Page 3 of FCC Form 350 will
encompass both the legal and engineering sections of the
application.

considered a party to this application.
An investment company, insurance company or trust
department of a bank is not considered a party to this
application, IF its aggregated holding accounts for less than
20% of the outstanding votes in the applicant AND IF:
(1)

such entity exercises no influence or control over the
corporation, directly or indirectly; and

(2)

such entity has no representatives among the officers
and directors of the corporation.

B. Notification Requirements. All applicants must comply
with the requirements of 47 C.F.R. Section 73.1030.
Specifically, applicants must notify United States
Government radio astronomy installations, radio receiving
installations, and FCC monitoring stations of the proposed
facility and its possible impact on their operations. The
Commission need not be informed of the date of such
notification.

ANY OTHER APPLICANT: Each executive officer,
member of the governing board and owner or holder of 5%
or more of the votes in the applicant is considered a party to
the application.

C. Tech Box: The applicant must accurately specify the
information requested in Items 1 through 3 of the Tech
Box. Conflicting data found elsewhere in the application
will be disregarded. All items must be completed. The
response "on file" is not acceptable. The response "not
applicable" is not acceptable unless otherwise noted below.

H. Item 9: Anti-Drug Abuse Act Certification. This
question requires the applicant to certify that neither it nor
any party to the application is subject to denial of federal
benefits pursuant to the Anti-Drug Abuse Act of 1988, 21
U.S.C. Section 862.

D. Item 1: Channel. The proposed channel must be between
201 and 300. See 47 C.F.R. Section 73.201.

Section 5301 of the Anti-Drug Abuse Act of 1988 provides
federal and state court judges the discretion to deny federal
benefits to individuals convicted of offenses consisting of
the distribution or possession of controlled substances.
Federal benefits within the scope of the statute include FCC
authorizations. A "Yes" response to Item 9 constitutes a
certification that neither the applicant nor any party to this
application has been convicted of such an offense or, if it
has, it is not ineligible to receive the authorization sought
by this application because of Section 5301.

E. Item 2: Effective Radiated Power. The effective radiated
power must be entered in kilowatts, and rounded pursuant
to 47 C.F.R. Section 73.212.
F.

Item 3: Transmitter Power Output. The transmitter
power output (TPO) must be specified in kilowatts, and
rounded pursuant to 47 C.F.R. Section 73.212.

G. Item 4: Constructed Facility. The applicant must certify
that the facility was constructed as authorized in the
underlying construction permit. If there are any differences
between the facilities constructed compared with those
authorized in the construction permit, the applicant may
need to seek approval for the change on FCC Form 349.
See 47 C.F.R. Section 73.1251.

NOTE: With respect to this question, the term "party to the
application" includes if the applicant is an individual, that
individual; if the applicant is a corporation or
unincorporated association, all officers, directors, or
persons holding 5 percent or more of the outstanding stock
or shares (voting and/or non-voting) of the applicant; all
members if a membership association; and if the applicant
is a partnership, all general partners and all limited partners,
including both insulated and non-insulated limited partners,
holding a 5 percent or more interest in the partnership.

H. Item 5: Special Operating Conditions. The special
operating conditions are located on the final pages of the
construction permit. Attach exhibits, if required, to
document compliance with the special operating conditions.
NOTE: SPECIAL OPERATING CONDITIONS MAY
PROHIBIT AUTOMATIC PROGRAM TEST
AUTHORITY.

INSTRUCTIONS FOR SECTION III: PREPARER'S
CERTIFICATION AND ENGINEERING DATA

Automatic Program Test Authority: The permittee of an
FM Translator or Booster station may begin program tests
upon filing FCC Form 350 with the FCC. See 47 C.F.R.
Section 74.14. This provision does not apply if the
underlying construction permit contains a special
operating condition prohibiting automatic program test
authority.

A. Preparer's Certification. When someone other than the
applicant has prepared the engineering section of FCC
Form 350, Section III requires that person to certify, to the
best of his/her knowledge and belief, the veracity of the
technical data supplied.
The Section III preparer's
certification on Page 3 of FCC Form 350 need not be

6

I.

Item 6: Transmitter Power Output. The applicant must
certify that the transmitter power output (TPO) produces
the authorized effective radiated power. The TPO to
produce the authorized effective radiated power is
calculated as follows: TPO equals
Effective

Radiated

Power

(Antenna power gain) x (Transmission/System Efficiency)
Applicants should remember to change percent values to
decimal form before calculating TPO. For example, 86%
becomes 0.86.
J.

Item 7: Directional antenna. The applicant must certify
that the facility does not use a directional antenna, or in the
case of a directional antenna facility, the applicant must
certify that the antenna was mounted in accordance with the
specific instructions provided by the antenna manufacturer,
and is oriented in the authorized direction. See Section
74.1235(i).

FCC NOTICE REQUIRED BY THE PAPERWORK
REDUCTION ACT
We have estimated that each response to this collection of
information will take 1 hour. Our estimate includes the time to
read the instructions, look through existing records, gather and
maintain the required data, and actually complete and review the
form or response. If you have any comments on this burden
estimate, or on how we can improve the collection and reduce
the burden it causes you, please e-mail them to [email protected] or
send them to the Federal Communications Commission, AMDPERM,
Paperwork
Reduction
Project
(3060-0404),
Washington, DC
20554. Please DO NOT SEND
COMPLETED APPLICATIONS TO THIS ADDRESS.
Remember - you are not required to respond to a collection of
information sponsored by the Federal government, and the
government may not conduct or sponsor this collection, unless it
displays a currently valid OMB control number of if we fail to
provide you with this notice. This collection has been assigned
an OMB control number of 3060-0404.
THE FOREGOING NOTICE IS REQUIRED BY THE
PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13,
OCTOBER 1, 1995, 44 U.S.C. Section 3507.

7

Approved by OMB
3060-0404

Federal Communications Commission
Washington, D. C 20554

FCC 350
APPLICATION FOR AN FM TRANSLATOR
OR FM BOOSTER STATION LICENSE

FOR
FCC
USE
ONLY

FOR COMMISSION USE ONLY
FILE NO.

Section I - General Information
1.

Legal Name of the Applicant
Mailing Address
City

State or Country (if foreign address)

Telephone Number (include area code)

E-Mail Address (if available)

FCC Registration Number

2.

Call Sign

ZIP Code

Facility Identifier

Contact Representative (if other than licensee/permittee)

Firm or Company Name

Mailing Address

3.

City

State or Country (if foreign address)

Telephone Number (include area code)

E-Mail Address (if available)

If this application has been submitted without a fee, indicate reason for fee exemption (see 47 C.F.R. Section 1.1114):
Governmental Entity

4.

Noncommercial Educational Licensee

Other

Facility Information:
a.
b.

FM Booster

FM Translator

Community or communities being served:
Community(ies)

5.

ZIP Code

State

Purpose of Application:
Cover construction permit (list original construction permit file number -- starts with the
prefix BPFT or BPFTB):
Modify an authorized license (list license file number -- starts with the prefix BLFT,
BMLFT, BLFTB, or BMLFTB):
Amend a pending application
If an amendment, submit as an Exhibit a listing by Section and Question Number
of the portions of the pending application that are being revised.

Exhibit No.

FCC Form 350
April 2001

NOTE: In addition to the information called for in this section, an explanatory exhibit providing full particulars must be
submitted for each question for which a ''No'' response is provided. See General Instruction I.
Section 11 - Legal
1.

Certification. Applicant certifies that it has answered each question in this application
based on its review of the application instructions and worksheets. Applicant further
certifies that where it has made an affirmative certification below, this certification
constitutes its representation that the application satisfies each of the pertinent standards
and criteria set forth in the application instructions and worksheets.

Yes

No

2.

Conditions. Licensee/Permittee certifies that all terms, conditions, and obligations set forth
in the underlying construction permit have been fully met.

Yes

No

See Explanation
in Exhibit No.

3.

Changed Circumstances. Licensee/Permittee certifies that, apart from changes already
reported, no cause or circumstance has arisen since the grant of the underlying construction
permit which would cause any statement or representation contained in the construction
permit application to be incorrect now.

Yes

No

See Explanation
in Exhibit No.

4.

Programming. The applicant is the licensee of the primary station or the applicant
certifies that written authority has been obtained from the licensee of the primary station
whose programming is to be retransmitted.

Yes

No

See Explanation
in Exhibit No.

5.

Station ready for operation. The applicant certifies that the station is now in satisfactory
operating condition and ready for regular operation.

Yes

No

See Explanation
in Exhibit No.

6.

Station identification. The applicant certifies that it will comply with applicable station
identification rules. See 47 C.F.R. Sections 73.1201 and 74.1283.

Yes

No

See Explanation
in Exhibit No.

7.

Character Issues. Applicant certifies that neither applicant nor any party to the application
has or has had any interest in, or connection with:

Yes

No

See Explanation
in Exhibit No.

Yes

No

See Explanation
in Exhibit No.

a.

b.

any broadcast application in any proceeding where character issues were left
unresolved or were resolved adversely against the applicant or party to the
application; or
any pending broadcast application in which character issues have been raised.

8.

Adverse Findings. Applicant certifies that, with respect to the applicant and any party to
the application, no adverse finding has been made, nor has an adverse final action been
taken by any court or administrative body in a civil or criminal proceeding brought under
the provisions of any law related to the following: any felony; mass media-related
antitrust or unfair competition; fraudulent statements to another governmental unit; or
discrimination.

9.

Anti-Drug Abuse Act Certification. Applicant certifies that neither applicant nor any
party to the application is subject to denial of federal benefits pursuant to Section 5301 of
the Anti-Drug Abuse Act of 1988, 21 U.S.C. Section 862.

FCC Form 350 (Page 2)
April 2001

Yes

No

I certify that the statements in this application are true, complete, and correct to the best of my knowledge and belief, and are made
in good faith. I acknowledge that all certifications and attached Exhibits are considered material representations. I hereby waive any
claim to the use of any particular frequency as against the regulatory power of the United States because of the previous use of the
same, whether by license or otherwise, and request an authorization in accordance with this application. (See Section 304 of the
Communications Act of 1934, as amended.)
Typed or Printed Name of Person Signing

Typed or Printed Title of Person Signing

Signature

Date

SECTION III PREPARER'S CERTIFICATION
I certify that I have prepared Section III (Engineering Data) on behalf of the applicant, and that after such preparation, I have
examined and found it to be accurate and true to the best of my knowledge and belief.
Name

Relationship to Applicant (e.g., Consulting Engineer)

Signature

Date

Mailing Address

City

State or Country (if foreign address)

Telephone Number (include area code)

E-Mail Address (if available)

ZIP Code

WILLFUL FALSE STATEMENTS ON THIS FORM AR-E PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE,
TITLE 18, SECTION I 00 1), 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).

FCC Form 350 (Page 3)
April 2001

Section III - Engineering
TECHNICAL SPECIFICATIONS
Ensure that the specifications below are accurate. Contradicting data found elsewhere in this application will be disregarded. All
items must be completed. The response ''on file'' is not acceptable.
TECH BOX

1.

Channel:

2.

Effective Radiated Power:

kW (H)

3

Transmitter Power Output:

kW

kW
(V)

NOTE: In addition to the information called for in this section, an explanatory exhibit providing full particulars must be
submitted for each question for which a ''No'' response is provided.
CERTIFICATION
All applicants must complete this section.

4.

Constructed Facility. The facility was constructed as authorized in the underlying
construction permit.

Yes

No

See Explanation
in Exhibit No.

5.

Special Operating Conditions. The facility was constructed in compliance with all special
operating conditions, terrns, and obligations described in the construction permit.

Yes

No

See Explanation
in Exhibit No.

An Exhibit may be required. Review the underlying construction permit.

Exhibit No.

6.

Transmitter Power Output. The operating transmitter power output produces the
authorized effective radiated power.

Yes

No

See Explanation
in Exhibit No.

7.

Directional Antenna. The facility does not use a directional antenna or the antenna is
mounted in accordance with the specific instructions provided by the antenna manufacturer
and is oriented in the proper direction.

Yes

No

See Explanation
in Exhibit No.

PREPARER'S CERTIFICATION ON PAGE 3 MUST BE COMPLETED AND SIGNED.

FCC Form 350 (Page 4)
April 2001