Form 310 final

10/25/21, 2:13 PM

IBFS Form - IBFS Portal

FCC 310IBFS

Approved by
OMB No. 30601035

Estimated time
per response: 6
hours
Edition date:

April 2023

APPLICATION FOR AN INTERNATIONAL
HIGH FREQUENCY BROADCAST STATION
LICENSE
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

City
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State

Zip Code/Postal Code

Country

Attention

Title

Phone

Fax

Email

Relationship
Same

3. Construction Permit covered by this application
Call Sign 
Placeholder



Date of Grant

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Construction Began



File Number

Site Location

Construction Completed


Is the station in satisfactory operating condition and ready for regular operating?
Yes
No

Application Fees




Will a fee be paid?
Yes
No
1b. If yes, select the appropriate fee code for the application


MNN

Waivers
Does the Applicant request a waiver(s) of the Commission's rules?
Yes
No

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
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

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

MI



Last Name

Suffix



Title



Signature

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

IBFS Form - IBFS Portal

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).

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