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Application For Assignments Of Authorization And Transfers Of Control Form. This is a Official Federal Forms form and can be use in Federal Communications Commission (FCC).
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FEDERAL COMMUNICATIONS COMMISSION
Approved by OMB
3060 -0800
Information and Instructions
FCC Form 603
Est. Avg. Burden
Per Response:
1.75 Hrs
FCC Wireless Telecommunications Bureau
Application for Assignment of Authorization
or Transfer of Control
NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT OF 1974 AND
THE PAPERWORK REDUCTION ACT OF 1995
We have estimated that each response to this collection of information will take on average 1.75 hours. Our estimate includes the time to
read the instructions, look through existing records, gather and maintain 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, Washington, DC 20554, Paperwork Reduction Project (3060-0800). We will
also accept your comments via the Internet if you send them to PRA@fcc.gov. Please do not send completed application forms to this
address.
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 with this notice. This collection has been assigned OMB
control number 3060-0800.
The FCC is authorized under the Communications Act of 1934, as amended, to collect the personal information we request in this form. We
will use the information you provide to determine whether approving this application is in the public interest. If we believe there may be a
violation or potential violation of a statute, FCC regulation, rule or order, your application may be referred to the Federal, state, or local
agency responsible for investigating, prosecuting, enforcing or implementing the statute, rule, regulation or order. In certain cases, the
information in your application may be disclosed to the Department of Justice or a court or adjudicative body when (a) the FCC; or (b) any
employee of the FCC; or (c) the United States Government, is a party to a proceeding before the body or has an interest in the proceeding.
All parties and entities doing business with the Commission must obtain a unique identifying number called the FCC Registration Number
(FRN) and supply it when doing business with the Commission. Failure to provide the FRN may delay the processing of the application. This
requirement is to facilitate compliance with the Debt Collection Improvement Act of 1996 (DCIA). The FRN can be obtained electronically
from the FCC’s website at http://www.fcc.gov or by manually submitting FCC Form 160. FCC Form 160 is available from the FCC’s web site
at http://www.fcc.gov/formpage.html, by calling the FCC’s Forms Distribution Center at (800) 418-FORM (3676), or from the FCC’s Fax
Information System by dialing (202) 418-0177.
This notice is required by the Privacy Act of 1974, Public Law 93-579, December 31, 1974, 5 U.S.C. Section 552a(e)(3), and the Paperwork
Reduction Act of 1995, Public Law 104-13, October 1, 1995, 44 U.S.C. 3507.
FCC Form 603 – Instructions
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General Instructions
Purpose of Form
FCC Form 603 is a multi-purpose form. It is used to request
approval for an Assignment of Authorization (Assignment) or
Transfer of Control (Transfer) involving licenses in the Wireless
Radio Services. This form is also used to provide notification of a
consummated Assignment or Transfer that has previously been
consented to by the FCC or for which notification but not prior
consent is required. The data collected on the form is used by
the FCC to determine whether the public interest would be served
by approval of the requested Assignment or Transfer.
Schedule E (Schedule for Request for Extension of Time To
Consummate an Assignment of Authorization or a Transfer of
Control) This schedule is used to request additional time to
consummate a previously consented to Assignment or Transfer
that the parties will not consummate in the time previously allotted
to them by the FCC.
Each application, amendment, or other request must contain only
one Main Form but may contain as few or as many of the optional
schedules as necessary.
Main Form
The purpose of the Main Form is to obtain information sufficient to
identify the parties to the proposed Assignment or Transfer,
establish the parties' eligibility and qualifications for entering into
the Assignment or Transfer and classify the filing. The Main
Form also contains the required certifications and signature
blocks for both the Assignor/Transferor and the
Assignee/Transferee. The Main Form is required with every
filing.
(Note: The FCC Registration Number must be completed on the
Main Form for all application purposes.)
Schedules
In addition to the Main Form, which is required with every filing,
completion of certain schedule(s) may also be required. The
purposes of the optional schedules are as follows:
Schedule A (Schedule for Licensees that Received Bidding
Credits or Participate in the Installment Payment Plan, or
Involving Licenses Won in Closed Bidding) This schedule
establishes whether unjust enrichment provisions or other
restrictions apply.
Schedule B (Schedule for Defined Geographic Areas To Be
Partitioned or for Spectrum To Be Disaggregated) This schedule
is used for Assignment applications in geographically-licensed
services that involve partitioning of the licensed area or
disaggregation of the licensed spectrum. This schedule must be
used when the partitioned area involves FCC-defined geographic
boundaries (i.e., FCC licensing boundaries (Major Trading Areas
(MTAs), Basic Trading Areas (BTAs), etc.) or county boundaries.
Schedule C (Schedule for Undefined Geographic Areas To Be
Partitioned) This schedule is used for Assignment applications in
geographically-licensed services that involve partitioning of the
licensed area when the partitioned area cannot be described
using FCC-defined geographic boundaries or county boundaries.
This schedule must be used to provide the geographic
coordinates (latitude and longitude) that depict the periphery of
the partitioned area.
Schedule D (Schedule for Notification of Consummation of an
Assignment of Authorization or a Transfer of Control) This
schedule is used to notify the FCC that a previously consented to
Assignment or Transfer has been consummated.
FCC Form 603 – Instructions
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Types of Filings
Assignment of Authorization
An Assignment of Authorization involves a change in the identity of the holder of the License and generally entails the changing of the
Licensee’s name.
For an Assignment, the Assignor must request approval using FCC Form 603 and generally must receive prior consent (unless the
Assignment is Involuntary or a post-consummation notification of a pro forma Assignment) from the FCC before assigning its authorization(s).
For additional information regarding Assignments that can be filed without receiving prior consent from the FCC, see the sections titled
Involuntary Transactions and Post-Consummation Notifications of Pro Forma Transactions.
Both the Assignor and Assignee must sign the form. In addition, if required pursuant to Section 1.919 of the Commission’s Rules, the
Assignee must file FCC Form 602, FCC Ownership Disclosure Information for the Wireless Telecommunications Services, unless a current
and up-to-date FCC Form 602 is already on file at the FCC. For information regarding the filing of FCC Form 602, see Sections 1.919,
1.2112 of the Commission’s Rules.
Full Assignment of Authorization
When the authorization for all of the facilities of a station or market is assigned, this is called a “Full” Assignment of Authorization.
To apply for a full Assignment, the Assignor must complete the Authorizations To Be Assigned or Transferred section on the Main
Form by providing the Call Sign and Radio Service Code for each of the authorizations that are being assigned.
Partial Assignment of Authorization
When the authorization for some, but not all, of the facilities of a station or market is assigned, this is called a “Partial” Assignment
of Authorization.
To apply for a partial Assignment of a geographically-licensed authorization, the Assignor must complete the Authorizations To Be
Assigned or Transferred section on the Main Form by providing the Call Sign and Radio Service Code for each of the authorizations
that are being assigned as well as complete Schedule B and, if applicable, Schedule C.
To apply for a partial Assignment of a site-specific authorization, the Assignor must complete the Authorizations To Be Assigned or
Transferred section on the Main Form by providing the Call Sign and Radio Service Code for each of the authorizations that are
being assigned as well as complete other portions of the Authorizations To Be Assigned or Transferred section to fully describe the
partial Assignment.
Transfer of Control
A Transfer of Control involves (1) a change from less than 50 percent ownership to 50 percent or more ownership of a Licensee or (2) the
transfer of controlling interest in the ownership of a Licensee to another party or parties. See Section 1.948(b) of the Commission’s Rules. A
Transfer of Control involves a transfer of controlling interest in ownership but generally does not involve the changing of the Licensee’s name.
Refer to the applicable FCC rules and decisions for definitions of controlling interest and ownership.
For a Transfer, the Transferor must request approval using FCC Form 603 and generally must receive prior consent (unless the Transfer is
Involuntary or a post-consummation notification of a pro forma Transfer) from the FCC before transferring control of the Licensee’s
authorization(s). For additional information regarding Transfers that can be filed without receiving prior consent from the FCC, see the
sections titled Involuntary Transactions and Post-Consummation Notifications of Pro Forma Transactions.
Both the Transferor and Transferee must sign the form. In addition, if required pursuant to Section 1.919 of the Commission’s Rules, the
Transferee must file FCC Form 602, FCC Ownership Disclosure Information for the Wireless Telecommunications Services, unless a current
and up-to-date FCC Form 602 is already on file at the FCC.
Involuntary Transactions
An Involuntary Assignment or Transfer involves the death or legal disability of a Licensee, a member of a partnership, or a person directly or
indirectly in control of a corporation that is a Licensee. An application for an Involuntary Assignment or Transfer (Item 7 must be ‘Y’, Item 8a
must be ‘Involuntary’ and a date must be provided in Item 8b) must be filed within 30 days after the occurrence of such death or legal
disability. For additional information, see Section 1.948(g) of the Commission’s Rules. Note: Involuntary applications should also be filed
when a Licensee declares bankruptcy.
Post-Consummation Notifications of Pro Forma Transactions
In the case of a non-substantial (pro forma) Assignment or Transfer involving a telecommunications carrier, as defined in Section 153(44) of
the Communications Act, prior consent by the FCC is not required provided that the affected license(s) are not subject to unjust enrichment
provisions, the Assignment or Transfer does not involve a proxy contest, and the Assignor/Transferor provides notice of the transaction (Item
7 must be ‘Y’, Item 8a must be ‘Voluntary’, Item 9a must be ‘Y’, Item 9b must be ‘Y’ and a date must be provided in Item 9c) within 30 days of
completion of the Assignment or Transfer. For additional information, see Section 1.948(c)(1) of the Commission’s Rules.
FCC Form 603 – Instructions
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Notification of Consummation
For an Assignment, the Assignee must sign and submit the FCC Form 603 Main Form and Schedule D within the prescribed time frame
outlined below under the section titled 180-Day Period. For a Transfer, the Transferee must sign and submit the FCC Form 603 Main Form
and Schedule D within the prescribed time frame outlined below under the section titled 180-Day Period. Note: Notifications of
consummation do not have to be filed for post-consummation notifications of a pro forma Assignment or Transfer, or Involuntary Assignment
or Transfer.
Note: If parties do not wish to consummate the transaction, the Assignor (for an Assignment) or the Transferor (for a Transfer) may submit
an application to withdraw a previously consented to application.
Extension of Time To Consummate
For an Assignment, the Assignor must sign and submit the FCC Form 603 Main Form and Schedule E within the prescribed time frame
outlined below under the section titled One Hundred and Eighty-Day Period. For a Transfer, the Transferor must sign and submit the FCC
Form 603 Main Form and Schedule E within the prescribed time frame outlined below under the section titled One Hundred and Eighty-Day
Period.
180-Day Period
Assignments and Transfers must be consummated and notification provided to the Commission within 180 days of the date of public notice of
the FCC consent, and a Notification of Consummation (Main Form and Schedule D) must be filed no later than 30 days after the actual
consummation date, unless an Extension of Time To Consummate (Main Form and Schedule E) is filed prior to the expiration of this 180-day
period.
Note: If an Assignment or Transfer is not consummated within 180 days of public notice of approval and a timely filed Notification of
Consummation is not submitted or a timely filed request for an Extension of Time to Consummate is not submitted, FCC consent to that
transaction is no longer valid.
FCC Form 603 – Instructions
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Information Current and Complete
Information filed with the FCC must be kept current and complete. Parties to the application must notify the FCC regarding any substantial
and significant changes in the information furnished in the application. See Section 1.65 of the Commission’s Rules.
Applicable Rules and Regulations
Applicants should obtain the relevant parts of the Commission’s Rules, which are located in Part 47 of the Code of Federal Regulations
(CFR). Copies of Part 47 CFR may be purchased by contacting the Superintendent of Documents, Government Printing Office, Washington,
DC 20402, by calling (202) 512-1800 or by accessing the Government Printing Office’s website at http://www.access.gpo.gov.
Application Fees and Filing Locations
An application fee may be required with this form. To determine the required fee amount, refer to Subpart G of Part 1 of the Commission’s
Rules (47 CFR Part 1, Subpart G) and the current Wireless Telecommunications Bureau Fee Filing Guide or FCC Form 1070AT. FCC Form
1070AT provides the fee information specifically for FCC Form 603. For assistance with fees applicable to the radio services governed by
the Commission’s Rules, call (877) 480-3201 (TTY (717) 338-2824). The Wireless Telecommunications Bureau Fee Filing Guide can be
downloaded from the FCC's website at http://www.fcc.gov/fees, by calling the FCC's Forms Distribution Center at (800) 418-FORM (3676), or
from the FCC’s Fax Information System by dialing (202) 418-0177.
Paper applications requiring a fee must be mailed to the Federal Communications Commission, P.O. Box 358130, Pittsburgh, PA
15251-5130 or hand delivered to the Federal Communications Commission, c/o Mellon Client Service Center, Attention FCC Module
Supervisor, 500 Ross Street, Room 670, Pittsburgh, PA 15262-0001
Paper applications not requiring a fee must be mailed to the Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA
17325-7245 or hand delivered to the Federal Communications Commission, 1280 Fairfield Road, Gettysburg, PA 17325-7245.
Submission of Paper-Filed Forms
One original paper copy of this application is required to be filed with the Commission. The Main Form and the applicable schedules should
be submitted as one package, stapled in the upper left corner. The Main Form should be first, with the schedules attached in alphabetical
order.
Exhibits
Each document required to be filed as an exhibit should be current as of the date of filing. Each page of every exhibit must be identified with
the number or letter of the exhibit, the number of the page of the exhibit, and the total number of pages of the exhibit. If material is to be
incorporated by reference, see the instruction on incorporation by reference.
Note: Some Commission Rules require Applicants to attach one or more exhibits to an application in addition to the information requested in
the application form.
Incorporation by Reference
You may incorporate by reference documents, exhibits, or other lengthy showings already on file with the FCC only if the information
previously filed is more than one 8 1/2” by 11” page in length, all information therein is current and accurate in all significant respects, and the
reference states specifically where the previously filed information can be found (i.e., station call sign and application file number, title of
proceeding, docket number and legal citations), including exhibit and page references. Items that call for numbers or that can be answered
‘Y’ or ‘N’ or with other short answers must be answered directly without reference to a previous filing.
Assistance with Completing this Form
For assistance with this form, contact the Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA 17325-7245, or call
(877) 480-3201 (TTY (717) 338-2824).
Technical Assistance for Electronic Filers
For technical assistance with filing electronically, contact the Wireless Telecommunications Bureau Technical Support line at (877) 480-3201.
FCC Form 603 – Instructions
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Instructions for FCC Form 603 Main Form
General Information
Item 1 Indicate the purpose for which the application is being filed by inserting the appropriate two-letter abbreviation from the following list
(only one purpose may be specified).
AA - Assignment of Authorization
TC - Transfer of Control
AM - Amendment: To amend a previously filed, currently pending application. Use Item 2 to provide the File Number of the
previously filed application. All appropriate schedules must be completed and attached, and must accurately reflect the effect and
purpose of the amendment.
WD - Withdrawal: To withdraw a previously filed, currently pending or consented to application. Use Item 2 to provide the File
Number of the pending or consented to application.
NT - Required Notification: To notify the FCC that, within the required time period, an Assignment or Transfer has been
consummated.
EX - Request for Extension of Time: To request additional time to consummate an Assignment or Transfer.
Item 2 If the filing is an amendment or withdrawal of a previously filed application, provide the File Number of the original application. This
information can be obtained by using ULS Application Search or by contacting the FCC at (877) 480-3201 (TTY 717-338-2824).
Item 3a Enter ‘Y’ if this application is one in a series of related applications involving other wireless licenses. Otherwise, enter ‘N’.
The purpose of this item is to indicate whether the proposed transaction involves other wireless licenses not listed on this filing that are held
by the Licensee, affiliates of the Licensee, or third parties (e.g., spectrum swaps or multi-party transactions). For this purpose, "affiliates" is
defined in Section 1.2110(a)(4) of the Commission’s Rules, and includes parents, subsidiaries, or commonly-controlled entities. Where a
transaction involves the Assignment or Transfer of multiple licenses held by a single Licensee, a single form should be filed whenever
possible. Where a transaction involves the Assignment or Transfer of licenses by affiliated Licensees or third-party Licensees, a separate
form must be filed for each Licensee. Parties who seek to assign or transfer licenses as part of a larger transaction or plan on filing multiple
applications are strongly encouraged to contact the Wireless Telecommunications Bureau in advance of filing this form.
Item 3b If the response to 3a is ‘Y’ and this filing is the lead application, enter ‘Y’. Otherwise, enter ‘N’.
Item 3c If the response to 3b is ‘N’, provide the File Number of the lead application for this transaction. The lead application should contain
an exhibit fully describing the proposed transaction. Any additional applications included as part of the proposed transaction may crossreference this exhibit.
Item 3d Enter ‘Y’ if the transaction that is the subject of this filing also involves the Assignment or Transfer of non-wireless licenses or
authorizations for which Commission approval or notification is required (e.g., Section 214 authorizations, wireline or media authorizations).
Item 4 Enter ‘Y’ if attachments (other than associated schedules) are being filed with this application. Otherwise, enter ‘N’.
Note: Section 310(d) of the Communications Act requires the Commission to determine that the public interest, convenience, and necessity
would be served by the proposed Assignment or Transfer. To enable the Commission to make this determination, Applicants may in some
instances be required to provide, by means of an attachment, additional information not specifically requested elsewhere on FCC Form 603
to establish the qualifications of the Assignee or Transferee or to otherwise demonstrate that the proposed transaction is in the public
interest. The burden is on the Applicants to determine whether such additional information is necessary under Section 310(d) in light of the
circumstances of the particular transaction. For example, if: 1) the application involves a non-pro forma Assignment or Transfer of a license in
a subscriber-based service, and 2) the proposed Assignee or Transferee, its parent or any affiliate, directly or indirectly owns, controls, or
holds an attributable interest in any other entity authorized to provide FCC-regulated subscriber-based services in a geographic area that
overlaps the service area of a license that is the subject of the proposed Assignment or Transfer, the Applicants should generally file an
attachment with their FCC Form 603 setting forth the factual circumstances and describing how the proposed transaction meets the public
interest standard of Section 310(d). Applicants seeking further guidance on this issue are encouraged to contact the Wireless
Telecommunications Bureau in advance of filing FCC Form 603.
Fees and Waivers
Item 5a This item notifies the FCC that the Applicant is exempt from FCC application fees. If the response is ‘Y’, an exhibit demonstrating
the Applicant’s eligibility for exemption from FCC application fees must be submitted with this filing. For additional information regarding an
Applicant’s eligibility to be exempt from FCC application fees, see the current Fee Filing Guide or call (877) 480-3201 (TTY 717-338-2824).
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Item 5b If a request for waiver/deferral of the FCC application fees is being filed with the FCC in conjunction with this filing and the application
fees are not being submitted, enter ‘Y’. Otherwise, enter ‘N’. If ‘Y’, attach an exhibit with the date-stamped copy of the waiver/deferral
request filed with the Commission’s Office of the Managing Director/Office of General Counsel. Otherwise, enter ‘N’.
Item 6a If the filing includes a request for waiver of the Commission’s Rules (other than FCC application fees), enter ‘Y’ and attach an exhibit
specifying the rule section(s) for which a waiver is being requested and demonstrating a justification for the requested waiver. See Section
1.925 of the Commission’s Rules. Otherwise, enter ‘N’.
Item 6b If the response to 6a is ‘Y’, provide the number of rule sections involved (do not enter the actual rule section(s)).
Additional Transaction Information
Item 7a Enter ‘Y’ if the Assignment or Transfer has already occurred. Otherwise, enter ‘N’.
If the response to Item 7a is ‘Y’, the response to Item 8a is Voluntary, and the response to Item 9a or Item 9b is ‘N’, attach an exhibit
explaining the circumstances.
Item 7b If the response to Item 7a is ‘Y’, provide the date the event occurred.
Item 8 Indicate whether the Assignment or Transfer is Voluntary or Involuntary by checking the appropriate selection. For additional
information regarding involuntary transactions, see Section 1.948(g) of the Commission’s Rules.
Item 9a Enter ‘Y’ in this item if the application is a pro forma Assignment or Transfer. Otherwise, enter ‘N’. If the response to this item is ‘Y’,
a response to Item 9b is required.
A pro forma assignment of authorization is one for which the actual controlling party does not change. For example, if an authorization is
assigned by one wholly-owned subsidiary of a parent corporation to another wholly-owned subsidiary of the same corporation, this would be a
pro forma Assignment of Authorization.
A pro forma transfer of control is one for which the actual controlling party does not change. For example, a corporate restructuring that
changes the chain of ownership to the controlling corporation may give rise to a pro forma Transfer of Control of a Licensee.
Item 9b Enter ‘Y’ if this is a post-consummation notification of a pro forma Assignment or Transfer that is subject to the FCC's forbearance
procedures pursuant to Section 1.948(c)(1) of the Commission’s Rules. Otherwise enter ‘N’.
Item 10a For Assignments of Authorization only (purpose AA in Item 1): Enter ‘Y’ if this application is being filed to partition or disaggregate a
geographic-area license(s). Otherwise, enter ‘N’. If the response to this item is ‘Y’, Schedule B and, if applicable, Schedule C must be
completed. For additional information, see Section 1.948(f) of the Commission’s Rules.
Item 10b For Assignments of Authorization only (purpose AA in Item 1): Enter ‘Y’ if this application is being filed to partially assign a sitebased license(s). Otherwise, enter ‘N’. For additional information, see Section 1.948(e) of the Commission’s Rules.
Item 11 This item indicates how the Assignment or Transfer is to be accomplished. If the facilities and other assets are to be sold, answer
this item ‘S’. If stock or other ownership interests in the Licensee or entity controlling the Licensee are to be assigned or transferred to
another entity, answer this item ‘T’. If the Assignment or Transfer is to be accomplished pursuant to court order (e.g., to an estate, debtor-inpossession, or trustee), answer this item ‘C’. If the Assignment or Transfer is to be accomplished by a court-supervised reorganization, or
liquidation, answer this item ‘R’. If the response is ‘O’, explain in an exhibit how the Assignment or Transfer is to be accomplished.
Designated Entity Information
Item 12a Enter ‘Y’ if the Assignment or Transfer involves any licenses that were originally granted before April 25, 2006 and that were
awarded with bidding credits within the last five years and/or any licenses that were originally granted after April 25, 2006, and that were
awarded with bidding credits within the last ten years. Otherwise, enter ‘N’.
The initial grant date is the date that the license was originally granted by the Commission after an auction, even if the license was acquired
in the secondary market. The initial grant date is not the date on which the Commission granted an assignment or transfer of control of the
license.
If the response to this item is ‘Y’ the license may be subject to the FCC’s unjust enrichment rules. See Sections 1.2111(d), (e) of the
Commission’s Rules. If the response to this item is ‘Y’, Schedule A must be completed.
Item 12b Enter ‘Y’ if the Assignment or Transfer involves a license that was originally awarded subject to the FCC’s installment payment
program. Otherwise, enter ‘N’.
If the response to this item is ‘Y’, the license may be subject to the FCC’s unjust enrichment rules. See Sections 1.2111(c), (e) of the
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Commission’s Rules. If the response to this item is ‘Y’, Schedule A must be completed.
Item 12c Enter ‘Y’ if the Assignment or Transfer involves a license that was originally awarded pursuant to closed bidding within the last five
years. Otherwise, enter ‘N’.
If the response to this item is ‘Y’, the license may be subject to assignment or transfer restrictions. See Sections 24.709 and 24.839 of the
Commission’s Rules. If the response to this item is ‘Y’, Schedule A must be completed.
Competition Related Information
Item 13 Enter ‘Y’ if this application for Assignment or Transfer involves a license that may be used for interconnected mobile voice and/or
data services that would create a geographic overlap with another license, that also could be used to provide interconnected mobile voice
and/or data services, in which the Assignee/Transferee already holds direct or indirect interests (of 10 percent or more), either as a Licensee
or spectrum lessee/sublessee. Otherwise, enter ‘N’.
Item 14a Enter ‘Y’ if the Assignment or Transfer application involves Cellular Radiotelephone, Broadband PCS, or Specialized Mobile Radio
(SMR) license(s) and if the Assignee/Transferee holds a 10 percent or greater direct or indirect interest in any entity that has access (through
license authorizations, leases, or subleases) to 10 MHz or more of such spectrum in a geographic area or market. Otherwise, enter ‘N’.
If ‘Y’, specify in an exhibit all geographic areas/markets (e.g., BTA, CMA, county, etc.) where there are spectrum overlaps and the total
amount of spectrum that the Assignee/Transferee will hold and/or lease in each geographic area/market.
Item 14b Enter ‘Y’ if the Assignment or Transfer will result in the loss of one or more service provider(s)/competitor(s) in any of the overlap
geographic areas/markets. Otherwise, enter ‘N’.
Broadband Radio Service and Educational Broadband Service Information
These items enable the FCC to determine whether the Assignee/Transferee complies with Section 27.1202 of the Commission’s Rules.
Item 15a If the proposed facilities will be used to provide multichannel video programming, enter ‘Y’. Otherwise, enter ‘N’.
Item 15b If response to 15a is ‘Y’, and the Applicants will operate, control or have an attributable interest in a cable television system
whose franchise area is located within the geographic service area of the proposed facilities, enter ‘Y’. Otherwise, enter ‘N’.
If ‘Y’, provide an exhibit explaining how the Assignee/Transferee complies with Section 27.1202 of the Commission’s Rules or justifying a
waiver of that rule. If a waiver of the Commission’s Rule(s) is being requested, 6a must be answered ‘Y’.
This item enables the FCC to determine whether the Assignee/Transferee complies with Section 27.1202 of the Commission’s Rules.
Item 16 Enter ‘Y’ if the Assignee/Transferee complies with the programming requirements contained in Section 27.1203 of the Commission’s
Rules. Otherwise, enter ‘N’.
If ‘N’, provide an exhibit explaining how the Assignee/Transferee complies with Section 27.1203 of the Commission’s Rules or justifying a
waiver of that rule. If a waiver of the Commission’s Rule(s) is being requested, 6a must be answered ‘Y’.
Licensee/Assignor Information
Items 17 through 29 identify the person or entity that is applying to assign the authorizations (Assignment of Authorization) or the Licensee in
a Transfer of Control.
Item 17 This item indicates the legal entity type of the Assignor (Assignment) or Licensee (Transfer). Select Individual, Unincorporated
Association, Trust, Government Entity, Corporation, Limited Liability Company, General Partnership, Limited Partnership, Limited Liability
Partnership, Consortium, or Other. When selecting ‘Other’, provide a description of the legal entity.
Item 18 Enter the ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique entity identifier for
everyone doing business with the Commission.
The FRN can be obtained electronically through the FCC webpage at
http://wireless.fcc.gov/uls or by manually submitting FCC Form 160.
FCC Form 160 is available for downloading from
http://www.fcc.gov/formpage.html, by calling the FCC's Forms Distribution Center at (800) 418-3676, or the FCC’s Fax Information System by
dialing (202) 418-0177. Failure to provide the FRN will prevent the Commission from processing the application.
Items 19-27 Complete either Item 19 or Item 20, depending on whether the Assignor/Licensee is an individual or company, respectively. If
completing Item 20, enter the individual to contact in Item 21. You may enter a post office box number in Item 22 or a street address in Item
23, or enter information for both items. Enter the city, state, and zip code in Items 24, 25, and 26. Refer to FCC Form 603 Main Form
Instructions, Appendix I, for a list of valid state, jurisdiction, and area abbreviations. Enter a telephone number, including area code, in Item
27.
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Note: The full legal name is required for Items 19 and 20.
Items 28 and 29 Enter the Assignor/Licensee fax number and e-mail address, if desired and available.
Failure to respond to FCC correspondence sent to the address of record may result in dismissal of an application, liability for forfeiture, or
revocation of an authorization.
Demographics of Assignor/Licensee (Optional)
Item 30 The information is optional and is requested for informational purposes only. Responses to this item will in no way affect processing
of applications.
Assignor/Licensee Contact Representative
Items 31-41 These items identify the contact representative for the Assignor/Licensee, if different from the Assignor/Licensee. This is usually
the headquarters office of a large company, the law firm or other representative of the Assignor/Licensee, or the person or company that
prepared or submitted the application on behalf of the Assignor/Licensee. If there is a question about the application, an FCC representative
will communicate with the contact representative.
If the contact representative is the same as the Assignor/Licensee, check the box and do not complete the remaining items in this section. If
the contact representative is not the same as the Assignor/Licensee, then provide the information and complete this section as follows:
Either the Individual Name or the Company Name is required.
If Individual Name is completed, then Company Name and Attention to are not required.
If Company Name is completed, then either an Individual Name or the Attention to is required.
Either a PO Box or a Street Address is required. Both may be provided.
City, State and Zip Code are required.
Telephone Number is required (including area code).
FAX Number and E-Mail Address are optional.
Transferor Information (for transfers of control only)
Items 42 through 54 identify the person or entity that is applying for consent to transfer control of the Licensee.
Item 42 This item indicates the legal entity type of the Transferor. Select Individual, Unincorporated Association, Trust, Government Entity,
Corporation, Limited Liability Company, General Partnership, Limited Partnership, Limited Liability Partnership, Consortium, or Other. When
selecting ‘Other’, provide a description of the legal entity.
Item 43 Enter the Transferor’s ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique entity
identifier for everyone doing business with the Commission. The FRN can be obtained electronically through the FCC website 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, by calling (800) 418-FORM (3676), or from Fax Information System by dialing (202) 418-0177. Failure to
provide the FRN will prevent the Commission from processing the application.
Items 44-52 Complete either Item 44 or Item 45, depending on whether the Transferor is an individual or company, respectively. If
completing Item 45, enter the individual to contact in Item 46. You may enter a post office box number in Item 47 or a street address in Item
48, or enter information for both items. Enter the city, state, and zip code in Items 49, 50, and 51. Refer to FCC Form 603 Main Form
Instructions, Appendix I, for a list of valid state, jurisdiction, and area abbreviations. Enter a telephone number, including area code, in Item
52.
Note: The full legal name is required for Items 44 and 45.
Items 53 and 54 Enter the Transferor fax number and e-mail address, if desired and available.
Failure to respond to FCC correspondence sent to the address of record may result in dismissal of an application, liability for forfeiture, or
revocation of an authorization.
Demographics of Transferor (Optional)
Item 55 The information is optional and is requested for informational purposes only. Responses to this item will in no way affect processing
of applications.
Transferor Contact Representative
Items 56-66 These items identify the contact representative for the Transferor, if different from the Transferor. This is usually the
headquarters office of a large company, the law firm or other representative of the Transferor, or the person or company that prepared or
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submitted the application on behalf of the Transferor. If there is a question about the application, an FCC representative will communicate
with the contact representative.
If the contact representative is the same as the Transferor, check the box and do not complete the remaining items in this section. If the
contact representative is not the same as the Transferor, then provide the information and complete this section as follows:
Either the Individual Name or the Company Name is required.
If Individual Name is completed, then Company Name and Attention To are not required.
If Company Name is completed, then either an Individual Name or the Attention To is required.
Either a PO Box or a Street Address is required. Both may be provided.
City, State and Zip Code are required.
Telephone Number is required (including area code).
FAX Number and E-Mail Address are optional.
Assignee/Transferee Information
Items 67 through 81 identify the person or entity that is applying to become or control the Licensee of the authorizations listed in this
application. For an Assignment of Authorization, the information provided in these items will become the Licensee’s name, address, and
telephone number of record, and the authorizations will be sent to this address. The Assignee is the party that will become the new Licensee
if the application is granted. In an application for consent to transfer control of the License, the Transferee is the party that will have a
controlling interest in the Licensee.
Item 67 This item indicates the legal entity type of the Assignee or Transferee. Select Individual, Unincorporated Association, Trust,
Government Entity, Corporation, Limited Liability Company, General Partnership, Limited Partnership, Limited Liability Partnership,
Consortium, or Other. When selecting ‘Other’, provide a description of the legal entity.
Item 68 Enter the Assignee/Transferee’s ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique
entity identifier for everyone doing business with the Commission. The FRN can be obtained electronically through the FCC website 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, by calling (800) 418-FORM (3676), or from Fax Information System by dialing (202) 418-0177. Failure to
provide the FRN will prevent the Commission from processing the application.
Items 69-70 Complete either Item 69 or Item 70, depending on whether the Assignee/Transferee is an individual or company, respectively.
Note: The full legal name is required for Items 69 and 70.
Item 71 If completing Item 70, enter the contact person for the Assignee/Transferee.
Item 72 Enter the real party in interest’s ten-digit FRN assigned by the Commission Registration System (CORES). The FRN is a unique
entity identifier for everyone doing business with the Commission. The FRN can be obtained electronically through the FCC website 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, by calling (800) 418-FORM (3676), or from Fax Information System by dialing (202) 418-0177. If the
Assignee or Transferee is also the real party in interest, enter the Assignee’s or Transferee’s FRN in this item. Failure to provide the FRN
will prevent the Commission from processing the application.
Item 73 The Assignee or Transferee must identify the real party (parties) in interest. If the Assignee or Transferee is also the real party in
interest, enter the Assignee’s or Transferee’s name in this item. If a party other than the Assignee or Transferee is the real party in interest
(e.g., a parent or other controlling entity), enter that party's name in this item. If there is more than one real party in interest, attach an exhibit
detailing all parties in interest.
The real party in interest is defined as a person who “has an ownership interest, or will be in a position to actually or potentially control the
operation of the station.” Astroline Communications Co. Ltd. v. FCC, 857 F.2d 1556, 1564 (D.C. Cir. 1988); see also In Re Applications of
Georgia Public Telecommunications Commission, et al., MM Docket No. 89-337, 7 FCC Rcd 7996 ( 1992); In Re Applications of Madalina
Broadcasting, et al., MM Docket No. 91-100, 8 FCC Rcd 6344 (1993).
Items 74-79 Enter the address and telephone number of the person to whom the FCC should send correspondence. You may enter a post
office box number in Item 74 or a street address in Item 75, or enter information for both items. Enter the city, state, and zip code in Items
76, 77, and 78, respectively. Refer to FCC Form 603 Main Form Instructions, Appendix I, for a list of valid state, jurisdiction, and area
abbreviations. Enter a telephone number, including area code, in Item 79.
Items 80 and 81 Enter the Assignee/Transferee fax number and e-mail address, if desired and available.
Failure to respond to FCC correspondence sent to the address of record may result in dismissal of an application, liability for forfeiture, or
revocation of an authorization.
Demographics of Assignee/Transferee (Optional)
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Item 82 The information is optional and is requested for informational purposes only. Responses to this item will in no way affect processing
of applications.
Assignee/Transferee Contact Representative
Items 83-93 These items identify the contact representative for the Assignee/Transferee, if different from the Assignee/Transferee. This is
usually the headquarters office of a large company, the law firm or other representative of the Assignee/Transferee, or the person or
company that prepared or submitted the application on behalf of the Assignee/Transferee. If there is a question about the application, an
FCC representative will communicate with the contact representative.
If the contact representative is the same as the Assignee/Transferee, check the box and do not complete the remaining items in this section.
If the contact representative is not the same as the Assignee/Transferee, then provide the information and complete this section as follows:
Either the Individual Name or the Company Name is required.
If Individual Name is completed, then Company Name and Attention To are not required.
If Company Name is completed, then either an Individual Name or the Attention To is required.
Either a PO Box or a Street Address is required. Both may be provided.
City, State and Zip Code are required.
Telephone Number is required (including area code).
FAX Number and E-Mail Address are optional.
Ownership Disclosure Information
Item 94a Enter ‘Y’ if the Assignee/Transferee is required to file FCC Form 602, Ownership Disclosure Information for the Wireless
Telecommunications Services.
Item 94b If 94a is ‘Y’, provide the File Number of the FCC Form 602 submitted in conjunction with this application or already on file with the
FCC.
Alien Ownership Questions
These items enable the FCC to determine whether an Applicant is eligible under Section 310(a) and (b) of the Communications Act of 1934,
as amended, to hold or have ownership interests in a License. The Assignee/Post-transfer Licensee is required to answer these questions
only if it is filing FCC Form 603 for one of the following purposes indicated in Item 1: Assignment of Authorization or Transfer of Control. An
Assignee/Post-transfer Licensee using FCC Form 603 for any other purpose is not required to answer these questions. Any applicant that
answers ‘Y’ to Items 96 – 99a must provide an attachment explaining the circumstances. The FCC will otherwise dismiss the Application
without further consideration.
Item 95 The Assignee/Post-transfer Licensee filing FCC Form 603 for one of the purposes indicated above must answer Item 95. The FCC
cannot grant an authorization to a foreign government or the representative of a foreign government. Therefore, if the true and correct
answer to Item 95 is ‘Y’, Assignee/Post-transfer Licensee is not eligible to hold a license and the FCC will dismiss the application without
further consideration.
Items 96-98 The FCC cannot grant an authorization to provide common carrier, broadcast, or aeronautical fixed service to any Applicant for
which the true and correct answer to any of Items 96 - 98 is ‘Y’. Any Applicant that answers ‘Y’ to any of Items 96 – 98 must provide an
attachment explaining why the requested license(s) is exempt from the prohibitions contained in Section 310(b)(1)-(3) of the Communications
Act of 1934. The FCC will otherwise dismiss the application without further consideration.
Item 99a Enter ‘Y’ if the Assignee/Post-transfer Licensee is directly or indirectly controlled by any other corporation of which more than onefourth 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 corporation organized under the laws of a foreign country. Otherwise, enter ‘N’. If the answer is ‘Y’, and if the requested license(s)
authorizes the provision of a common carrier, broadcast, or aeronautical fixed service, it is necessary for the Assignee/Post-transfer Licensee
to have or obtain approval of the Assignee's/Post-transfer Licensee’s indirect foreign ownership pursuant to Section 310(b)(4) of the
Communications Act of 1934. Accordingly, any applicant that answers ‘Y’ to item 99a must provide an attachment explaining the
circumstances. The FCC will otherwise dismiss the Application without further consideration. In the attachment, the Applicant must
demonstrate either that (i) the requested license(s) is exempt from the provisions of Sections 310(b)(4), or (ii) allowing the Assignee/Posttransfer Licensee to hold the requested license is consistent with the Commission’s policies pursuant to Section 310 (b)(4). If the Applicant
cannot demonstrate that the requested license(s) is exempt from the provisions of Sections 310 (b)(4), it must include in its Section 310(b)(4)
showing a description of the Assignee’s Post-transfer Licensee’s indirect foreign ownership, along with information regarding any approvals
of the foreign ownership obtained from the Commission. In general, the Commission has indicated that there is a strong presumption that
indirect foreign ownership of common carrier radio Licensees by entities whose home markets are in countries that are members of the World
Trade Organization (WTO) does not raise competitive concerns. If more than 25 percent of the ownership of an entity that directly or
indirectly controls a common carrier radio Licensee is attributable to parties whose home markets are in non-WTO member countries, the
presumption ode not apply, and the Commission will evaluate whether those markets offer effective competitive opportunities to U.S.
investors in the same service sector. See Rules and Policies on Foreign Participation in the U.S. Telecommunications Market, IB Docket No.
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97-142, Report and Order and Order on Reconsideration, FCC 97-398, 12 FCC Rcd 23,891 ¶¶ 97-118, 131 (1997).
For additional guidance on how the Commission analyzes foreign ownership issues, see Foreign Ownership Guidelines for FCC Common
Carrier and Aeronautical Radio Licenses, DA 04-3610, 19 FCC Rcd 22,612 (IB 2004), corrected by Erratum, DA 06-1242, 21 FCC Rcd6484
(IB 2006).
Item 99b Enter ‘Y’ if the Assignee/Post-transfer Licensee has received a ruling(s) under Section 310(b)(4) of the Communications Act with
respect to the same radio service(s) and geographic coverage area(s) involved in this application. Otherwise, enter ‘N’.
If the answer to 99b is ‘Y’, include in the attachment required by Item 99a the citation(s) of the applicable declaratory ruling(s) by DA/FCC
number, the FCC Record citation, if available, release date, and any other identifying information.
If the answer to 99b is ‘N’, attach as an exhibit, a date-stamped copy of a request for a foreign ownership ruling pursuant to Section 310(b)(4)
of the Communications Act of 1934. It is not necessary to file a request for a foreign ownership ruling if the Applicant includes in the
attachment required by Item 99a a showing that the requested license(s) is exempt from the provisions of Sections 310(b)(4).
Basic Qualification Questions
Items 100-102 These items enable the FCC to determine whether an Assignee/Transferee is eligible under Sections 310(d) and 308(b) of the
Communications Act of 1934, as amended, to hold or have ownership interest in a station license. The Assignee/Transferee is required to
answer these questions only if it is filing FCC Form 603 for one of the following purposes indicated in Item 1: Assignment of Authorization or
Transfer of Control. An Assignee/Transferee using FCC Form 603 for any other purpose is not required to answer these questions. If the
answer to any one or more of Items 100-102 is ‘Y’, attach as an exhibit a statement explaining the circumstances and a statement giving the
reasons why the Assignee/Transferee believes that grant of the application would be in the public interest notwithstanding the actual or
alleged misconduct. If the Assignee or Transferee responds ‘Y’ to any question and has previously provided a statement and explanation
regarding the circumstances as an attachment to a prior application filed in ULS, and the facts and circumstances are unchanged, the
Applicants may refer to the previous application by identifying the application file number and indicating the disposition of the prior
application.
Assignor/Transferor Certification Statements
By signing this form, the Assignor/Transferor certifies that the statements listed in this section are true, complete, correct, and made in good
faith.
Items 103-105 These items must be completed. To be acceptable for filing, applications and amendments must be signed in accordance
with Part 1 of the FCC rules. The signor must be a person authorized to sign the application. Paper originals of applications must bear an
original signature. On paper originals, neither rubber-stamped nor photocopied signatures are acceptable. For filers filing electronically via
ULS, the electronic signature shall consist of the name of the person authorized to sign typed on the application as a signature.
Assignee/Transferee Certification Statements
By signing this form, the Assignee/Transferee certifies that the statements listed in this section are true, complete, correct, and made in good
faith.
Items 106-108 These items must be completed. To be acceptable for filing, applications and amendments must be signed in accordance
with Part 1 of the FCC rules. The signor must be a person authorized to sign the application. Paper originals of applications must bear an
original signature. On paper originals, neither rubber-stamped nor photocopied signatures are acceptable. For filers filing electronically via
ULS, the electronic signature shall consist of the name of the person authorized to sign typed on the application as a signature.
Authorizations To Be Assigned or Transferred
If this is an application for full Assignment or a Transfer of Control, use this section to identify the authorizations to be assigned (complete
only Items 109 (Call Sign), 110 (Radio Service) and 116 (Constructed)). Complete at least one entry in this section and use a separate entry
for each authorization. If necessary, attach additional copies of this page to list more authorizations.
If this is an application for a partial Assignment in a site-specific service, use this section to identify the authorizations to be assigned
(complete Items 109-116, as appropriate). Complete at least one entry in this section and use a separate entry for each authorization. If
necessary, attach additional copies of this page to list more authorizations.
Item 109 In this item list the call signs of the authorizations to be assigned or transferred. Call signs are located on FCC Authorizations.
Note:
Assigning call signs without specifying which specific locations, paths (Microwave Services only), or frequencies are to be
assigned for that call sign will result in all locations, paths, and frequencies for that call sign being assigned. Use Item 111
to specify which (if any) specific locations are to be assigned. Use Item 112 to specify which (if any) specific paths
(Microwave Services only) are to be assigned. Use Items 113, 114 and 115 to specify which (if any) specific frequencies
are to be assigned.
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Item 110 In this item list the Radio Service of the call sign to be assigned.
Item 111 In this item list the location numbers to be assigned. Location numbers are located on FCC Authorizations.
Note:
Assigning locations without specifying which specific frequencies are to be assigned for that location will result in all
frequencies at that location being assigned. Use Items 113, 114 and 115 to specify which (if any) specific frequencies are
to be assigned.
Item 112 In this item list the path numbers to be assigned (Microwave Services only). Path numbers are located on FCC Authorizations.
Note:
Assigning paths without specifying which specific frequencies are to be assigned for that path will result in all frequencies
on that path being assigned. Use Items 113, 114 and 115 to specify which (if any) specific frequencies are to be
assigned.
Item 113 In this item list the frequency number to be assigned. Frequency numbers are located on FCC authorizations.
Items 114 and 115 In these items list the frequencies, in Megahertz (MHz), to be assigned. Enter the center frequency, or the lower
frequency of a frequency band, in Item 114. If applicable, enter the upper frequency of a frequency band in Item 115. Frequencies are
located on FCC authorizations or can be located by accessing the Universal Licensing System’s license search.
Item 116 Enter ‘Y’ if the facilities have been constructed. Otherwise, enter ‘N’.
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Instructions for Schedule for Licensees that Received Bidding Credits or Participate in the
Installment Payment Plan, or Involving Licenses Won in Closed Bidding
FCC Form 603, Schedule A
FCC Form 603 Schedule A is a supplementary schedule. Complete this schedule when an Assignment or Transfer involves a license(s) that
was originally awarded through the competitive bidding process and the original Licensee or current Licensee obtained installment payments,
bidding credits, or was otherwise subject to special provisions applicable to entrepreneurs, and closed bidding licenses. This schedule
establishes whether the Assignee (Assignment of Authorization) or the post-transaction Licensee (Transfer of Control) is eligible for the same
special provisions as the current Licensee, or whether unjust enrichment provisions or other restrictions apply.
Bidding Credits
Item 1 Enter ‘Y’ if the full amount of bidding credits awarded with regard to each subject license has been paid as part of unjust enrichment
payment(s) in previous transaction(s). Otherwise, enter ‘N’. If ‘Y’ is entered, Item 2 is not required to be completed.
Item 2 Check the appropriate selection: a) the Applicant qualifies for the same designated entity status as the current Licensee; b) the
Applicant qualifies for a different designated entity status than the current Licensee; or, c) the Applicant does not qualify for any designated
entity status.
If either selection ‘a’ or ‘b’ is checked, attach an exhibit that includes revenue information pursuant to the Commission’s Rules.
Installment Payments
Item 3 Enter ‘Y’ if all installment payments for each subject license have been paid in full. Otherwise, enter ‘N’. If ‘Y’ is entered, Item 4 is not
required to be completed.
Item 4 Check the appropriate selection: a) the Applicant qualifies for the same designated entity status as the current Licensee; b) the
Applicant qualifies for a different designated entity status than the current Licensee or, c) the Applicant does not qualify for the installment
payment plan.
If either selection ‘a’ or ‘b’ is checked, attach an exhibit that includes revenue and asset information pursuant to the Commission’s Rules.
Closed Bidding Licenses
Item 5 Enter ‘Y’ if construction notifications have been submitted for each of the subject licenses. Otherwise, enter ‘N’. If ‘Y’ is entered, Item
6 is not required to be completed.
Item 6 Check the appropriate selection: a) the Applicant qualifies for closed bidding, or b) the Applicant does not qualify for closed bidding.
If selection ‘a’ is checked, attach an exhibit that includes revenue and asset information pursuant to the Commission’s Rules.
Revenue and Asset Information for the Applicants
Item 7 If filing an Amendment application, check the block if modifying the Revenue and Asset Information from what was provided on the
original filing. When modifying the data that was provided on the original filing, only enter the items that have changed. This item is not
required to be completed on the original filing.
Gross Revenue Disclosure
Most Recent Reportable Year
Item 8a Enter ‘Y’ if the Applicant and any predecessors-in-interest were in existence and had gross revenues for the most recent reportable
year. If ‘Y’, complete Items 8b and 8c. Enter ‘N’ if the Applicant and any predecessors-in-interest were not in existence for the most recent
reportable year and explain why in an attachment.
One Year Prior to Most Recent Reportable Year
Item 9a Enter ‘Y’ if the Applicant and any predecessors-in-interest were in existence and had gross revenues for one year prior to the most
recent reportable year. If ‘Y’, complete Items 9b and 9c. Enter ‘N’ if the Applicant and any predecessors-in-interest were not in existence for
one year prior to the most recent reportable year and explain why in an attachment.
Two Years Prior to Most Recent Reportable Year
Item 10a Enter ‘Y’ if the Applicant and any predecessors-in-interest were in existence and had gross revenues for two years prior to the most
recent reportable year. If ‘Y’, complete Items 10b and 10c. Enter ‘N’ if the Applicant and any predecessors-in-interest were not in existence
for two years prior to the most recent reportable year and explain why in an attachment.
Average Gross Revenue
Item 11 The Universal Licensing System will calculate the average gross revenue for the reported years provided in Items 8, 9 and 10.
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Asset Disclosure
Item 12 Enter the total assets disclosed as of the application filing date.
Financial Statements
Item 13 Check if the Applicant used audited financial statements or unaudited financial statements prepared in accordance with Generally
Accepted Accounting Principles (GAAP) and certified by Applicant’s chief financial officer or the equivalent.
Revenue and Asset Information for Disclosable Interest Holder (DIH)
Item 14 Select the proper block to Add, Modify, or Delete a DIH. If Adding, complete Items 15 through 21. If Modifying, enter only the items
changed. If Deleting, complete the Entity Name or the Individual Name and the FRN of the DIH. Modify and Delete are used for
Amendments of a previously filed application. If necessary, attach additional copies of this page to list more DIHs.
Disclosable Interest Holder
Item 15 Select the proper block for either Entity Name or Individual name of the Disclosable Interest Holder and provide Entity Name or
Individual name and the FCC Registration Number (FRN) of the DIH.
Gross Revenue Disclosure
Most Recent Reportable Year
Item 16a Enter ‘Y’ if the DIH and any predecessors-in-interest were in existence and had gross revenues for the most recent reportable year.
If ‘Y’, complete Items 16b and 16c. Enter ‘N’ if the DIH and any predecessors-in-interest were not in existence for the most recent reportable
year and explain why in an attachment.
One Year Prior to Most Recent Reportable Year
Item 17a Enter ‘Y’ if the DIH and any predecessors-in-interest were in existence and had gross revenues for one year prior to the most recent
reportable year. If ‘Y’, complete Items 17b and 17c. Enter ‘N’ if the DIH and any predecessors-in-interest were not in existence for one year
prior to the most recent reportable year and explain why in an attachment.
Two Years Prior to Most Recent Reportable Year
Item 18a Enter ‘Y’ if the DIH and any predecessors-in-interest were in existence and had gross revenues for two years prior to the most
recent reportable year. If ‘Y’, complete Items 18b and 18c. Enter ‘N’ if the DIH and any predecessors-in-interest were not in existence for
two years prior to the most recent reportable year and explain why in an attachment.
Average Gross Revenue
Item 19 The Universal Licensing System will calculate the average gross revenue for the reported years provided in Items 16, 17 and 18.
Asset Disclosure
Item 20 Enter the total assets disclosed as of the application filing date.
Financial Statements
Item 21 Check if the DIH used audited financial statements or unaudited financial statements prepared in accordance with Generally
Accepted Accounting Principles (GAAP) and certified by DIHs chief financial officer or the equivalent.
Revenue and Asset Information for Affiliate
Item 22 Select the proper block to Add, Modify, or Delete an Affiliate. If Adding, complete Items 23 through 29. If Modifying, enter only the
items changed. If Deleting, complete the Entity Name or the Individual Name and the FRN of the Affiliate. Modify and Delete are used for
Amendments of a previously filed application. If necessary, attach additional copies of this page to list more Affiliates.
Affiliate
Item 23 Select the proper block for either Entity Name or Individual name of the Affiliate and provide Entity Name or Individual name and the
FCC Registration Number (FRN) of the Affiliate.
Gross Revenue Disclosure
Most Recent Reportable Year
Item 24a Enter ‘Y’ if the Affiliate and any predecessors-in-interest were in existence and had gross revenues for the most recent reportable
year. If ‘Y’, complete Items 24b and 24c. Enter ‘N’ if the Affiliate and any predecessors-in-interest were not in existence for the most recent
reportable year and explain why in an attachment.
One Year Prior to Most Recent Reportable Year
Item 25a Enter ‘Y’ if the Affiliate and any predecessors-in-interest were in existence and had gross revenues for one year prior to the most
recent reportable year. If ‘Y’, complete Items 25b and 25c. Enter ‘N’ if the Affiliate and any predecessors-in-interest were not in existence for
one year prior to the