Federal Communications Commission Washington, D. C. 20554 Approved by OMB 3060-0906 FCC 317 INSTRUCTIONS FOR ANNUAL DTV ANCILLARY/SUPPLEMENTARY SERVICES REPORT 1. WHO MUST FILE. A permittee operating pursuant to digital special temporary authority or a licensee of a (1) digital commercial or noncommercial educational full power television broadcast station; (2) digital low power television broadcast station; (3) digital translator television broadcast station; or (4) digital Class A television broadcast station (referred to herein collectively as “DTV licensee or permittee”) is required to file FCC 317 each year on December 1st, setting forth whether it provided ancillary or supplementary services at any time during the twelve month period ending on the preceding September 30th. The name of the DTV licensee or permittee should be stated exactly as it appears on the station's existing license, permit, or authorization. The current street address or post office box used by the licensee or permittee for receipt of Commission correspondence should be set forth. 2. Ancillary/Supplementary Services. Ancillary or supplementary services are all services provided on that portion of the station's digital spectrum capacity or bitstream not needed to provide the required one free, over-the-air video broadcast signal to viewers, except that any video broadcast signal provided at no direct charge to viewers shall not be considered ancillary or supplementary. Such services include, but are not limited to, computer software distribution, data transmissions, teletext, interactive materials, aural messages, paging services, audio signals, subscription video, and the like. 3. Annual DTV Services Fee. Pursuant to Section 336(e) of the Telecommunications Act of 1996, and the Commission's regulations implementing that provision, each commercial and noncommercial educational DTV licensee and permittee must remit to the Commission an amount equal to 5% of the gross revenues derived by the licensee or permittee from any ancillary or supplementary services for which payment of a subscription fee or charge is required in order to receive the service or for which the licensee or permittee, directly or indirectly, receives compensation from a third party in exchange for the transmission of material provided by that third party (other than commercial advertisement used to support broadcasting for which a subscription fee is not required). See 47 C.F.R. Section 73.624(g). 4. Filing Procedures. The Commission is currently developing electronic versions of various broadcast station application and reporting forms, such as this annual report 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 assessing and filing the application or report electronically via the Internet. Any change in the name of the DTV licensee or permittee, which does not involve a change in ownership requiring prior Commission approval, can be communicated to the Commission by letter. To report any changes in the mailing address previously used by the licensee or permittee, FCC Form 5072, entitled "Change in Official Mailing Address for Broadcast Stations," should be promptly transmitted to the Commission. See 47 C.F.R. Section 1.5. 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 http://www.CORES@fcc.gov or by calling 1-877-480-3201. Facility ID Number. The DTV Facility ID Number is the same as the NTSC station’s Facility ID Number which can be obtained at the FCC's Internet Website at www.fcc.gov/mb. Once at this website, scroll down and selected CDBS Public Access. You can also obtain your Facility ID Number by calling (202)-418-1600. Further, the Facility ID Number is now included on all DTV authorizations and postcards. Mandatory electronic filing of FCC Form 317 commenced on November 1, 2006. See Public Notice, “Media Bureau Implements Mandatory Electronic Filing of FCC Form 317,” 21 FCC Rcd 11754 (2006). Paper versions of FCC Form 317 will not be accepted for filing after October 31, 2006, unless accompanied by an appropriate request for waiver of the electronic filing requirement. Such waivers, however, will not be routinely granted and the applicant must plead with particularity the facts and circumstances warranting relief. Form 317 is available for electronic filing by using the Media Bureau’s Consolidated Database System (CDBS). This system provides the public with FCC 317 Instructions October 2011 American LegalNet, Inc. www.FormsWorkFlow.com the ability to fill out FCC Form 317 on-line via the Internet from the Media Bureau’s Web Site, http://www.fcc.gov/mb, and to file it electronically with the Commission. 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 or if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-0906. FCC Form 159 – Concurrent with the submission of FCC Form 317, each commercial and noncommercial educational DTV licensee and permittee is required to remit to the Commission a payment in the amount of 5% of the gross revenues derived from the provision of its ancillary or supplementary services. FCC Form 159 can be filed electronically or mailed to the Federal Communications Commission, Media Bureau, P.O. Box 979089, St. Louis, MO 63197-9000. See 47 C.F.R. Section 0.401(b). THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13, OCTOBER 1, 1995, 44 U.S.C. 3507. In completing FCC Form 159 (February 2003 Revised Edition), the DTV licensee or permittee should specify in Section C on: line 23 line 24 line 27 line 28 line 29 - the DTV station's call sign payment code "MDTA" the fee remitted (5% of line 29) DTV station's facility ID number. total gross revenues derived from feeable ancillary and supplementary services NOTE. Further information concerning the Commission's policies and regulations regarding DTV ancillary or supplementary fees is set forth in the Report and Order in MM Docket No. 97-247, 14 FCC Rcd 3259 (1998); Report and Order in MM Docket No. 98-203, 16 FCC Rcd 19042 (2001); and Report and Order in MB Docket No. 07-91, 23 FCC Rcd 2994 (2007). See also 47 C.F.R. Section 73.624(g). 5. Certification. The person certifying the accuracy of the information in this report must be the individual licensee (or permittee), a general partner in the licensee (or permittee) partnership, or an appropriate officer in the licensee (or permitte) corporation or association. FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT We have estimated that each response to this collection of information will take 2 to 4 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 burden estimate, or on how we can improve the collection and reduce the burden it causes you, please e-mail them to pra@fcc.gov or send them to the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0906), Washington, DC 20554. Please DO NOT SEND COMPLETED APPLICATIONS TO THIS ADDRESS. Remember - you are not required to respond to a collection of American LegalNet, Inc. www.FormsWorkFlow.com 2 Approved by OMB 3060-0906 Federal Communications Commission Washington, D. C. 20554 FOR FCC USE ONLY FCC 317 ANNUAL DTV ANCILLARY/SUPPLEMENTARY SERVICES REPORT FOR DIGITAL TELEVISION STATIONS FOR COMMISSION USE ONLY SECTION I - GENERAL INFORMATION FILE NO. 1. City State or Country (if foreign address) Telephone Number (include area code) E-Mail Address (if available) FCC Registration Number Facility ID Number ZIP Code Call Sign 2. 3. For the twelve-month period ended September 30th, has the DTV licensee or permittee provided, at any time during the period, an ancillary or supplementary service as defined by 47 C.F.R. Section 73.624? Yes No If ''No,'' complete Question 7 and submit this Report to the Commission. If ''Yes,'' proceed to Questions 4 through 7. 4. Ancillary/Supplementary Services Provided. Briefly describe below the service provided; whether a fee was charged for the provision of such service; and, if so, the amount of gross revenues received therefrom and the amount of DTV bitstrearm used to provide such service. FCC Form 317 October 2011 American LegalNet, Inc. www.FormsWorkFlow.com 5. Total amount of gross revenues derived from feeable ancillary or supplementary services: 6. Has the DTV licensee or permittee remitted to the Commission, through the filing of FCC Form 159, a payment in the amount of 5% of the gross revenues derived from the feeable ancillary or supplementary services? 7. $ Yes No N/A Certification. I certify that I have examined this Report and that, to the best of my knowledge and belief, all statements in this Report are true, correct and complete. Typed or Printed Name of Person Signing Typed or Printed Title of Person Signing Signature Date WILLFUL FALSE STATEMENTS 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)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503). FCC Form 317 (Page 2) American LegalNet, Inc. www.FormsWorkFlow.com