8. Does the applicant, or any party to the application, have a petition on file to migrate to
the expanded band (1605-1705 kHz) or a permit or license either in the existing band or
expanded band that is held in combination (pursuant to the 5 year holding period allowed)
with the AM facility proposed to be modified herein?
If Yes, provide particulars as an Exhibit.
Exhibit No.
The APPLICANT hereby waives any claim to the use of any particular frequency or of the electromagnetic spectrum as
against the regulatory power of the United States because use of the same, whether by license or otherwise, and
requests and authorization in accordance with this application. (See Section 304 of the Communications Act of 1934, as
amended).
The APPLICANT acknowledges that all the statements made in this application and attached exhibits are considered
material representations and that all the exhibits are a material part hereof and are incorporated herein as set out in full in
CERTIFICATION
Name Signature
Title Date
2. I certify that the statements in this application are true, complete, and correct to the best of my knowledge and belief,
and are made in good faith.
1. By checking Yes, the applicant certifies, that, in the case of an individual applicant, he
or she is not subject to a denial of federal benefits that includes FCC benefits pursuant
to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. Section 862, or, in the
case of a non-individual applicant (e.g., corporation, partnership or other unincorporated
association), no party to the application is subject to a denial of federal benefits that
includes FCC benefits pursuant to that section. For the definition of a "party" for these
purposes, see 47 C.F.R. Section 1.2002(b).
Telephone Number
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
FCC NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT AND THE PAPERWORK REDUCTION ACT
The solicitation of personal information requested in this application is authorized by the Communications Act of 1934, as amended. The
Commission will use the information provided in this form to determine whether grant of the application is in the public interest. In reaching that
determination, or for law enforcement purposes, it may become necessary to refer personal information contained in this form to another
government agency. In addition, all information provided in this form will be available for public inspection. If information requested on the form is
not provided, the application may be returned without action having been taken upon it or its processing may be delayed while a request is made to
provide the missing information. Your response is required to obtain the requested authorization.
Public reporting burden for this collection of information is estimated to average 639 hours and 53 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the
burden, can be sent to the Federal Communications Commission, Records Management Branch, Paperwork Reduction Project (3060-0627),
Washington, D. C. 20554. Do NOT send completed forms to this address.
THE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OF 1974, P.L. 93-579, DECEMBER 31, 1974, 5 U.S.C. 552a(e)(3), AND THE
PAPERWORK REDUCTION ACT OF 1980, P.L. 96-511, DECEMBER 11, 1980, 44 U.S.C. 3507.
FCC 302-AM (Page 3)
August 1995
Yes
No
Yes
No
