FCC 601 Schedule B March 2018 - Page 1 FCC 601 Schedule B MARKET/CHANNEL BLOCK INFORMATION Schedule for Geographically Licensed Services Approved by OMB 3060 226 0798 See 601 Main Form Instructions for public burden estimate 1) Market Designator 2) Market Name 3) Channel Block 4) Sub-Market Designator 5) Type of bidding credit requested 6) Open/Closed Bidding 7) I Am Seeking A Tribal Lands Bidding Credit In This Market ( ) Y es ( ) N o ( ) Y es ( ) N o ( ) Y es ( ) N o TRIBAL LANDS INFORMATION 8) Market Designator 9) Channel Block 10) Name of Tribal Lands 11) Area, in square kms, of tribal lands contained within designated market 12) Indicate with an 223x224 those tribal lands where Applicant has secured the required certification(s) from the tribal governments [attach certification(s)] 13) The amount of bidding credit as defined by FCC Rules (by Market) 14) Additional amount of bidding credit requested (attach justification) Agreements 15a ) Agreements Regarding Designated Entities (e.g., Small Businesses and Rural Service Providers) and Closed Bidding. Has the Applicant entered into any agreements or arrangements, written or oral, which could affect its overall eligibility for designated entity benefits, including, where applicable, its eligibility to participate in closed bidding or its eligibility for the award of designated entity benefits for any particular license for which it claimed a bidding credit? If answering 221Y222, proceed to item 16, check 221Add222 for the Action Requested, select 221Designated Entity222 and/or 221Closed Bidding222 as the type of agreement, enter the unique identifying name of the agreement, and check the appropriate block of the party(ies) to agreement for either Entity Name or Individual Name. If filing is for an entity, enter the legal entity name. If filing is for an individual, enter the first name, middle initial, last name and suffix of the individual. Provide the FCC Registration Number (FRN) of the party(ies) to the agreement. Attach an exhibit summarizing the agreements (with appropriate references to specific provisions in the text of such agreements and instruments and the date(s) on which the Applicant entered into the agreements) and provide copies of the agreements. If the agreement allows a disclosable interest holder (DIH) that holds a ten percent or greater interest of any kind in the Applicant to use more than 25% of the spectrum capacity (as measured in megahertz) of any license subject to this application, provide in an exhibit: (1) the DIH222s name, FRN and its relationship to the Applicant; (2) the names and FRNs of the DIH222s Affiliates; (3) the percentage of spectrum capacity that the DIH uses or has an agreement to use for each license; (4) the gross revenues for each of the last three reportable years for the DIH and its Affiliates (for a small business bidding credit); (5) the combined number, if any, of commercial communications services subscribers to wireless, wireline, broadband, and cable services that the DIH and each of its Affiliates serve (along with the Federal Information Processing Standard (FIPS) numbers of each county where each entity has at least one subscriber) (for a RSP bidding credit); and (6) whether the Applicant asserts that the DIH is independently eligible for the RSP bidding credit. ( ) Yes ( ) No 15b ) Agreements with Other Parties and Joint Bidding Arrangements. Between the Form 175 deadline and through the release of the auction closing public notice, has the Applicant, or any party that controls or is controlled by the Applicant, entered into any partnerships, joint ventures, consortia, or other agreements, arrangements, and/or understandings of any kind relating to the licenses in this application, including any agreements that address or communicate directly or indirectly bids (including specific prices), bidding strategies (including the specific licenses on which to bid or not to bid), or the post-auction market structure. If answering 221Y222, proceed to item 16, check 221Add222 for the Action Requested, select the type of agreement, enter the unique identifying name of the agreement, and check the appropriate block of the party(ies) to agreement for either ( ) Yes ( ) No American LegalNet, Inc. www.FormsWorkFlow.com FCC 601 Schedule B March 2018 - Page 2 Entity Name or Individual Name. If filing is for an entity, enter the legal entity name. If filing is for an individual , enter the first name, middle initial, last name and suffix of the individual. Provide the FCC Registration Number of the party(ies) to the agreement. Attach an exhibit describing the terms and conditions and identifying all parties to the agreement or arrangement. 16) Agreement Identifier: Action Requested: Add Delete Type of Agreement: Collusion-Based Designated Entity Closed Bidding Bidding/Joint Bidding Joint Venture Partnership Consortium Post-Auction Market Structure Operational Transfer/Assignment Other (Description of Type of Agreement) Party(ies) to Agreement(s) Action Requested: Add Delete Entity Name: Legal Entity Name FCC Registration Number (FRN): Individual Name: First MI Last Suffix FCC Registration Number (FRN): Action Requested: Add Delete Entity Name: Legal Entity Name FCC Registration Number (FRN): Individual Name: First MI Last Suffix FCC Registration Number (FRN): Action Requested: Add Delete Entity Name: Legal Entity Name FCC Registration Number (FRN): Individual Name: First MI Last Suffix FCC Registration Number (FRN): Agreement Name: American LegalNet, Inc. www.FormsWorkFlow.com FCC 601 Schedule B March 2018 - Page 3 17) Additional Demographic Information (Not Required) Revenue and Asset Information 19) Revenue and Asset Information for the Applicant Purpose (Check Modify and complete all changes different from previously filed FCC Form 175) Gross Revenue Disclosure Most Recent Reportable Year 20a) Were the Applicant and any predecessors - in - interest in existence for a full year of the relevant period? If 221N222, explain why in an attachment. ( ) Y es N o If 221Y222, provide the following information. 20b) Gross Revenues $ (Format: 99,999.99) 20c) Year-end Date: (Date Format: MM/DD/YYYY) One Year Prior to Most Recent Reportable Year 21a) Were the Applicant and any predecessors - in - interest in existence for a full year of the relevant period? If 221N222, explain why in an attachment. ( ) Y es N o If 221Y222, provide the following information. 21b) Gross Revenues $ (Format: 99,999.99) 21c) Year-end Date: (Date Format: MM/DD/YYYY) Two Years Prior to Most Recent Reportable Year 22a) Were the Applicant and any predecessors - in - interest in existence for a full year of the relevant period? If 221N222, explain why in an attachment. ( ) Y es N o If 221Y222, provide the following information. 22b) Gross Revenues $ (Format: 99,999.99) 22c) Year-end Date: (Date Format: MM/DD/YYYY) Average Gross Revenue Asset Disclosure Financial Statements Applicant Status: Minority Owned Business Rural Telephone Company Woman Owned Business 18) Has any Revenue and Asset information changed for the Applicant, the Disclosable Interest Holder, or the Affiliate? If 221Y222, explain why in an exhibit. ( ) Y es N o Modify 23) Average Gross Revenue of Reported Years: $ (Format: 99,999.99) 24) Total Assets as of Application Filing Deadline: $ (Format: 99,999.99) 25) Audited or Unaudited (Check One) The Applicant used audited financial statements. The Applicant used unaudited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) and certified by the Applicant222s chief financial officer or the equivalent. American LegalNet, Inc. www.FormsWorkFlow.com FCC 601 Schedule B March 2018 - Page 4 Add Modify Delete FCC 601 Schedule B 26) Revenue and Asset Information for Each Disclosable Interest Holder (DIH) (including each of Applicant's Controlling Interests, and Affiliates of its controlling interests) Purpose (Select One) 27) D isclosable Interest Holder Entity Name: FCC Registration Number (FRN): Individual Name: First MI Last Suffix FCC Registration Number (FRN): Gross Revenue Disclosure Most Recent Reportable Year 28a) Were the D i