Convert to Class A Form (Schedule F)(final)(2023)

Not Yet Approved by OMB (Office of Management and Budget) 3060-0928

(DRAFT COPY - Not for submission)

December 2023

FCC Form 2100 Schedule F
Modification of a License to Convert LPTV
to Class A TV Station Application
File Number:

Call Sign:

Submit Date:

Estimated time per response - 2 hours

Facility ID:

FRN:

State:

City:
Service:

General
Information

Purpose:

Status:

Status Date:

Section

Question

Attachments

Are attachments (other than associated schedules) being

Filing Status:

Response

filed with this application?

Fees, Waivers,
and Exemptions

Section

Question

Fees

Is the applicant exempt from FCC application Fees?
Indicate reason for fee exemption:
Is the applicant exempt from FCC regulatory Fees?

Waivers

Does this filing request a waiver of the Commission's rule(s)?
Total number of rule sections involved in this waiver request:
Are the frequencies or parameters requested in this filing
covered by grandfathered privileges, previously approved by
waiver, or functionally integrated with an existing station?

Response

Applicant
Information

Applicant Name, Type, and Contact Information
Applicant

Address

Phone

Email

Applicant Type

Authorization Holder Name
Check box if the Authorization Holder name is being updated because of the sale (or transfer of control) of the
Authorization(s) to another party and for which proper Commission approval has not been received or proper notification
provided.

Contact
Representatives

Contact Name

Address

Phone

Email

Contact Type

Alien Ownership

Question

Response

1) Is the applicant a foreign government or the representative of any foreign government as specified in Section
310(a) of the Communications Act?
2) Is the applicant an alien or the representative of an alien? (Section 310(b)(1))
3) Is the applicant a corporation, or non-corporate entity, that is organized under the laws of any foreign
government? (Section 310(b)(2))
4) Is the applicant an entity of which more than one-fifth of the capital stock, or other equity or voting interest, is
owned of record or voted by aliens or their representatives or by a foreign government or representative
thereof or by any entity organized under the laws of a foreign country? (Section 310(b)(3))
5) Is the applicant directly or indirectly controlled by any other entity of which more than one-fourth of the capital
stock, or other equity or voting interest, is owned of record or voted by aliens, their representatives, or by a
foreign government or representative thereof, or by any entity organized under the laws of a foreign country?
(Section 310(b)(4))
6) Has the applicant received a declaratory ruling(s) under Section 310(b)(4) of the Communications Act?
7) In connection with this application, is the applicant filing a foreign ownership Petition for Declaratory Ruling
pursuant to Section 310(b)(4) of the Communications Act?

Basic Qualifying
Questions

Section

Question

Revoked Application

Has the Applicant or any party to this application had any
FCC station Authorization revoked or had any application for
an initial, modification or renewal of FCC station
Authorization denied by the Commission?

State or Federal

Has the Applicant or any party to this application, or any

Convictions

party directly or indirectly controlling the Applicant, ever
been convicted of a felony by any state or federal court?

Response

Channel and
Facility
Information

Section
Facility ID
State
City
DCA Channel
Designated Market Area

Question

Response

Antenna Location
Data

Section

Question

Antenna Structure

Do you have an FCC Antenna Structure Registration (ASR)

Registration

Number?
ASR Number

Coordinates (NAD83)

Latitude
Longitude
Structure Type

Overall Structure Height
Support Structure Height
Ground Elevation (AMSL)
Antenna Data

Height of Radiation Center Above Ground Level
Height of Radiation Center Above Mean Sea Level
Effective Radiated Power

Response

Antenna
Technical Data

Section

Question

Response

Antenna Type

Antenna Type
Do you have an Antenna ID?
Antenna ID

Antenna Manufacturer and

Manufacturer:

Model
Model
Rotation
Electrical Beam Tilt
Mechanical Beam Tilt
toward azimuth
Polarization
Elevation Radiation

Does the proposed antenna propose elevation radiation

Pattern

patterns that vary with azimuth for reasons other than the
use of mechanical beam tilt?
Uploaded file for elevation antenna (or radiation) pattern
data
Out-of-Channel Emission Mask:

Directional Antenna Relative Field Values (Pre-rotated Pattern)
Degree

Value

Degree

Value

Degree

Value

Degree

0

90

180

270

10

100

190

280

20

110

200

290

30

120

210

300

40

130

220

310

50

140

230

320

60

150

240

330

70

160

250

340

80

170

260

350

Additional Azimuths
Degree

VA

Value

Parties to the
Application (0)

Information not provided.

Attributable
Interest

Section

Question

Equity and Financial

Applicant certifies that equity and financial interests not set

Interests

forth by the applicant parties are non-attributable.

Other Authorizations

Does the applicant or any party to the application have an
attributable interest in any other broadcast station(s).

Response

License
Certifications

Section

Question

Constructed Facility

The facility constructed as authorized in the underlying
construction permit.

Special Operating

The facility was constructed in compliance with all special

Conditions

operating conditions, terms, and obligations described in the
construction permit.
An exhibit may be required. Review the underlying
construction permit.

Response

Legal
Certifications

Section

Question

Obligations

Licensee certifies that no technical changes have been
made since January 1, 2023.

Character Issues

Applicant certifies that neither applicant nor any party to the
application has or had any interest in, or connection with:
(a) any broadcast application in any proceeding where
character issues were left in unresolved or were
resolved adversely against the applicant or party to
the application; or
(b) any pending broadcast application in which character
issues have been raised.

Adverse Findings

Has the Applicant or any party to this application had an
adverse finding or an adverse final action taken by any court
or administrative body in a civil or criminal proceeding
brought under any law related to the following: any felony;
mass media-related antitrust or unfair competition;
fraudulent statements to another governmental unit; or
discrimination?

Class A Eligibility

Licensee certifies that, in the 90-day period preceding
January 5, 2023, the station: (1) broadcast a minimum of 18
hours per day, (2) broadcast an average of at least 3 hours
per week of programming that was produced within the
market area served by such station, or the market area
served by a group of commonly controlled LPTV stations
that carry common local programming produced within the
market area served by such group, and (3) was in
compliance with the Commission’s requirements applicable
to LPTV stations.

Continued Eligibility

License certifies that its station does, and will continue to,
broadcast: (a) a minimum of 18 hours per day; and (b) an
average of at least 3 hours per week of programming each
quarter produced within the market area served by the
station,or the market area served by a group of commonly
controlled low-power or Class A stations that carry common
local programming produced within the market area served
by such groups.

Main Studio

Licensee certifies that it has constructed and maintains a
main studio at a location in compliance with the
requirements of 47 C.F.R. Section 3.1125.

Public Inspection File

Licensee certifies that it maintains for its station a public
inspection file that includes the documentation required by
47 C.F.R. Section 73.3526.

Response

Certification

Section

Question

General Certification

The Applicant waives any claim to the use of any particular

Statements

frequency or of the electromagnetic spectrum as against the

Response

regulatory power of the United States because of the
previous use of the same, whether by authorization or
otherwise, and requests an Authorization in accordance with
this application (See Section 304 of the Communications Act
of 1934, as amended.).
The Applicant certifies that neither the Applicant nor any
other party to the application is subject to a denial of Federal
benefits pursuant to §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. This
certification does not apply to applications filed in services
exempted under §1.2002(c) of the rules, 47 CFR . See §1.
2002(b) of the rules, 47 CFR §1.2002(b), for the definition of
"party to the application" as used in this certification §1.2002
(c). The Applicant certifies that all statements made in this
application and in the exhibits, attachments, or documents
incorporated by reference are material, are part of this
application, and are true, complete, correct, and made in
good faith.
Authorized Party to Sign

FAILURE TO SIGN THIS APPLICATION MAY RESULT IN
DISMISSAL OF THE APPLICATION AND FORFEITURE
OF ANY FEES PAID
Upon grant of this application, the Authorization Holder may
be subject to certain construction or coverage requirements.
Failure to meet the construction or coverage requirements
will result in automatic cancellation of the Authorization.
Consult appropriate FCC regulations to determine the
construction or coverage requirements that apply to the type
of Authorization requested in this application.
WILLFUL FALSE STATEMENTS MADE ON THIS FORM
OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND
/OR IMPRISONMENT (U.S. Code, Title 18, §1001) AND/OR
REVOCATION OF ANY STATION AUTHORIZATION (U.S.
Code, Title 47, §312(a)(1)), AND/OR FORFEITURE (U.S.
Code, Title 47, §503).
I certify that this application includes all required and
relevant attachments.
I declare, under penalty of perjury, that I am an authorized
representative of the above-named applicant for the
Authorization(s) specified above.

FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT
We have estimated that each response to this collection of information will take 2 hours. 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 estimate, or on how we can improve the collection and reduce the burden it causes
you, please write the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0928), Washington,
DC 20554. We will also accept your comments via the Internet if your send them to [email protected]. 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 0MB control number or if we fail to provide you with this notice. This collection has been assigned an 0MB control
number of 3060-0928.

THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995,
P.L. 104-13, OCTOBER 1, 1995, 44 U.S.C. 3507

Attachments

Information not provided.