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IBFS Form - IBFS Portal
FCC 309IBFS NEW
Approved by
OMB No. 30601035
Estimated time
per response: 6
hours
Edition date:
April 2023
APPLICATION FOR AUTHORITY TO
CONSTRUCT OR MAKE CHANGES IN AN
INTERNATIONAL HIGH FREQUENCY
BROADCAST STATION
FOR OFFICAL USE ONLY
See Instructions Print Form
1. Applicant Information
FRN
Name
Doing Business As (DBA)
Street Address
Street Address 2
City
State
Zip Code/Postal Code
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Country
Attention
Title
Phone
Fax
Email
Applicant/Licensee Legal Entity Type
-- None --
Contact Same as Applicant
2. Contact Information
FRN
Name
Doing Business As (DBA)
Street Address
Street Address 2
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City
State
Zip Code/Postal Code
Country
Attention
Title
Phone
Fax
Email
Relationship
Same
3. Purpose of Application (check appropriate boxes)
Application is for:
New Station
Change in existing authorization
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Complete Section I plus any other Sections necessary to show all
substantial changes in information previously filed with the
Commission. Indicate below the sections completed
Options
Section I
Section II
Section III
Section IV
Section V
Section VI
4. THE APPLICANT confirms its understanding that it hereby 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. (See Section 304 of the Communications Act of 1934,
as amended.)
Yes
No
5. THE APPLICANT confirms its understanding that it represents that this application is not filed for the
purpose of impeding, obstructing, or delaying determination on any other application with which it
may be in conflict.
Yes
No
6. THE APPLICANT certifies that neither applicant nor any party to this application, nor any party
directly or indirectly controlling your company, 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.
Yes
No
7. THE APPLICANT acknowledges that all the statements made in this application and attached exhibits
are considered material representations, and that all the exhibits are a material part hereof and are
incorporated herein as it set out in full in the application.
Yes
No
Application Fees
Will a fee be paid?
Yes
No
1b. If yes, select the appropriate fee code for the application
MSN
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Waivers
Does the Applicant request a waiver(s) of the Commission's rules?
Yes
No
Section II - LEGAL QUALIFICATIONS
1. Legal identity of applicant (check appropriate box)
Individual
Partnership
Corporation
Government Entity
Other
2. Do you certify that you are not a foreign government or a representative of a foreign government?
Yes
No
3. Do you certify that you are not an alien, or the representative of an alien?
Yes
No
4. Do you certify that you are not a corporation organized under the laws of any foreign government?
Yes
No
5. Do you certify that you are not 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
6. Do you certify that you are not corporation 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, their
representatives, or by a foreign government or representative thereof, or by any corporations
organized under the laws of a foreign country?
Yes
No
7. Do you certify that the applicant or any party to the application has NOT had any FCC station
authorization or license revoked or had any application for an initial, modification or renewal of FCC
station authorization, license or construction permit denied by the Commission?
Yes
No
8. Do you certify that neither Applicant nor any party to this application, nor any party directly or
indirectly controlling your company, has EVER been convicted of a felony by any state or federal court?
Yes
No
9. Do you certify that NO court has finally adjudged the applicant, or any person directly or indirectly
controlling the applicant, guilty of unlawfully monopolizing or attempting to monopolize radio
communications, directly or indirectly, through control of manufacture or sale of radio apparatus,
exclusive traffic arrangement or any other means of unfair methods of competition?
Yes
No
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10. Do you certify that neither you nor any person directly or indirectly controlling the Applicant, is not
currently a party in any pending matter referred to in Questions 8 and 9.
Yes
No
Section III - FINANCIAL QUALIFICATIONS
1. The Applicant certifies that it has sufficient net liquid assets on hand or available from committed
sources to construct and operate the requested facilities for three months without revenue.
Yes
No
2. The applicant certifies that it has a reasonable assurance of a present firm intention for each
agreement to furnish capital or purchase capital stock by parties to the application, each loan by
banks, financial institutions or others, and each purchase of equipment on credit.
Yes
No
3. The Applicant can and will meet all contractual requirements as to collateral, guarantee, and capital
investment.
Yes
No
4. The Applicant has determined that a reasonable assurance exists that all such sources (excluding
banks, financial institutions, and equipment manufacturers) have sufficient net liquid assets to meet
these commitments.
Yes
No
Section IV - STATEMENT OF PROGRAM SERVICE OF BROADCAST
APPLICANT
1. Submit as an Exhibit an outline of the program plans and policies.
Attach File
Section V - EQUAL EMPLOYMENT OPPORTUNITY PROGRAM
1. If the Applicant proposes to employ five or more full-time employees, Applicant certifies that it is
filing simultaneously with this application a Model EEO Program Report on FCC Form 396-A.
Yes
No
Section VI - ENGINEERING DATA
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ANTENNA SITE INFORMATION:
1. Antenna location and Geographical Coordinates of the antenna site:
Add
Remove All
Actions
Street Address
Add
Remove All
Actions
Maximum Antenna Hight Above Mean Sea Level (Meters)
City
County
Country
State
Latitude Degrees
Latitude M
Maximum Antenna Hig
No data to display
2. Has the FAA been notified and cleared of proposed construction? (See Part 17 of FCC Rules)
Yes
No
3. Environmental Statement. Would a Commission grant of your application be a major action as
defined by 47 C.F.R. Section 1.1307?
Yes
No
4. Antenna Information
Add
Remove All
Actions
Make
Modal
Antenna Type
Attach file description of antenna if you selected
5. List of the transmitters
Add
Remove All
Actions
Manufacturer
Model
Number of Transmitters
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Power(Kilowatts)
Emission D
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Actions
IBFS Form - IBFS Portal
Manufacturer
Model
Number of Transmitters
Power(Kilowatts)
Emission D
No data to display
Confidential Treatment of Attachments
1. Is the Applicant requesting confidential treatment of an attachment(s) under section 0.459 of the
Commission's rules?
Yes
No
The Applicant acknowledges it must upload a supporting statement for the "confidential treatment
request(s)" identifying the applicable rule(s)
and providing other supporting materials or information : Link to section 0.459 of the Commission's
rules
1a. The Applicant also acknowledges it must upload both the Redacted Public version and the NonRedacted Confidential version of the attachment(s).
Attachment No.
File Name
Description of Attachment
Confidential
Action
No Attached Files
* Attach File
Certification Statements and Acknowledgements
In submitting this form
• The Applicant certifies that neither it nor any other party to the application is subject to a denial of
Federal benefits, including FCC 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 47
CFR § 1.2002(b) for the meaning of "party to the application" for these purposes. "This certification
does not apply to applications filed in services exempted under § 1.2002(c) of the rules, or to Federal
State or local governmental entities or subdivisions thereof, 47 CFR § 1.2002(c)."
• The Applicant certifies that all of its statements made in this Application and in the attachments or
documents incorporated by reference are material, are part of this Application, and are true, complete,
correct, and made in good faith.
First Name
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MI
Last Name
Suffix
Title
Signature
Date
2021-10-25
FAILURE TO SIGN THIS FORM MAY RESULT IN DISMISSAL
OF THE APPLICATION AND FORFEITURE OF ANY FEES PAID.
WILLFUL FALSE STATEMENTS MADE ON THIS FORM 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)), AND/OR FORFEITURE (U.S. Code, Title 47, Section 503).
Check appropriate box
Technical Director
Chief Operator
Registered Professional Engineer
Save as Draft
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Consultant
Review & Submit
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| File Type | application/pdf |
| File Modified | 2023-04-03 |
| File Created | 2021-10-25 |