Filing Instructions for One-Time Information Collection (08.24.23)

Draft

Not Yet Approved by OMB

OMB Control Number 3060-1308

August 2023

Estimated Time per Response – 6 hours

FEDERAL COMMUNICATIONS COMMISSION

One-Time Information Collection for

International Section 214 Authorization Holders

Instructions

Table of Contents

PRIVACY ACT STATEMENT 3

What is the Purpose 4

Who Must File 4

Surrender the International Section 214 Authorization 4

Accessing the Online Filing System 4

Obtaining an FCC Registration Number (FRN) 4

Publication of the One-Time Information Collection 5

Consequences for Failure to File a Timely Response 5

Consequences for False Statements 5

Log In & Entity (or Registrant) Verification (Questions 1 – 1.a.) 6

QUESTION 1 6

QUESTION 1.a 6

Identify All Current Authorization File Numbers Associated with FRN

(Questions 2 – 3.b) 6

QUESTION 2 6

QUESTION 2.a 7

QUESTION 2.b 7

QUESTION 3 7

QUESTION 3.a 7

QUESTION 3.b 8

Authorizations Subject to a Mitigation Agreement (Questions 4 – 5.b.) 8

QUESTION 4 8

QUESTION 5 8

QUESTION 5.a 8

QUESTION 5.b 8

Qualification for FCC’s Exemption from Completing Entirety of the Form (Questions 6-8)

9

QUESTION 6 9

QUESTION 7 10

QUESTION 8 10

Identify Whether the Authorization Holder Has Reportable Foreign Ownership

(Question 9) 11

QUESTION 9 11

Reportable Foreign Ownership (Questions 9.a – 13) 12

QUESTION 9.a 12

QUESTION 10 12

QUESTION 11 13

QUESTION 12 13

QUESTION 13 13

No Reportable Foreign Ownership Certification (Question 14) 14

QUESTION 14 14

Certification (Questions 15 - 17.b.) 14

QUESTION 15 14

QUESTION 16 14

QUESTION 17 14

QUESTION 17.a 14

QUESTION 17.b 14

FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT 16

PRIVACY ACT STATEMENT

Authority: The FCC is authorized to collect the information that is requested in this one-time collection pursuant to the authority contained in 47 U.S.C. 214, 307, 309, 310, 319, and 332, as well as 151, 152, 154(i)–(j) & (o), 155, 251(e)(3), 254, 257, 301, 303, 332, 402, 1302; and 5 U.S.C. 602(c) and 609(a)(3), as well as 47 CFR 1.10000–1.10018, 1.5000–1.5004, and 63.09–63.702.

Purpose: The information collected in this One-Time Information Collection is utilized by the FCC to regulate and process applications and other filings involving, among others, international section 214 authorizations, as well as to enforce FCC regulations and the Communications Act of 1934.

Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, as amended, the FCC may disclose information provided in this collection, as is determined to be relevant and necessary, outside the FCC as a routine use pursuant to 5 U.S.C. 552a(b)(3), including: to the public, except for material that is afforded confidential treatment, in accordance with section 0.459 of the FCC’s rules; to an FCC Bureau or Office or another government agency, or representative thereof, for purposes of obtaining information so long as it is relevant to the regulation of a license, authorization, or permit or a pending transaction of an FCC-issued license, authorization, or permit; to the Department of Treasury, State government, or a debt collection agency to collect a claim owed to the FCC; for law enforcement and investigation; and to non-federal personnel, including contractors, who have been engaged to assist the FCC in the performance of a contract service, grant, cooperative agreement, or other activity related to this system of records and who need to have access to the records in order to perform their activity.

A full, detailed list of the routine uses is published in the system of records notices associated with this collection, IB–1, International Bureau Filing System, which is available at https://www.fcc.gov/sites/default/files/sor-fcc-ib-1.pdf, and FCC-2, which is available at https://www.fcc.gov/sites/default/files/sor-fcc-2.pdf.

Disclosure: This information collection is mandatory. The FCC’s Evolving Risks Order & NPRM (Review of Int'l Section 214 Authorizations to Assess Evolving Nat'l Sec., L. Enf't, Foreign Pol'y, & Trade Pol'y Risks; Amend. of the Schedule of Application Fees Set Forth in Sections 1.1102 Through 1.1109 of the Commission's Rules, No. FCC 23-28) requires all international section 214 authorization holders to respond to a one-time collection to update the Commission's records regarding the foreign ownership of international section 214 authorization holders. The Commission is currently considering in this NPRM whether to cancel the authorizations of carriers that fail to timely respond to the One-Time Information Collection and to impose forfeitures or other measures where a carrier fails to respond in a timely or complete manner.

GENERAL INFORMATION AND REQUIREMENTS

1. What is the Purpose

On April 20, 2023, the Federal Communications Commission (Commission) adopted an Order (FCC 23-28) requiring all International Section 214 Authorization Holders (Authorization Holders) to respond to a one-time collection (One-Time Information Collection) to update the Commission’s records regarding their foreign ownership.

• The Order directed each Authorization Holder to identify its 10% or greater direct or indirect Foreign Interest Holders that hold such equity and/or voting interests, or a controlling interest, in the Authorization Holder (Reportable Foreign Ownership) as of thirty (30) days prior to the filing deadline.

• The Order required each Authorization Holder to certify as to the accuracy of the information provided.

2. Who Must File

All Authorization Holders must respond to the One-Time Information Collection.

3. Surrender the International Section 214 Authorization

Authorization Holders may surrender their International Section 214 Authorization(s) before the filing deadline and are encouraged to do so if the Authorization Holder no longer seeks to retain the authorization.

• Authorization Holders that surrender their International Section 214 Authorizations before the filing deadline do not need to respond to the One-Time Information Collection.

• Authorization Holders may file a surrender letter in the International Communications Filing System (ICFS) before the filing deadline.

4. Accessing the Online Filing System

• Each Authorization Holder must complete and submit the form online at [[add hyperlink]].

• Authorization Holders must log into the online system with the username and password for the FCC User Registration System.

• Verification of the username and password occurs through Okta integration.

5. Obtaining an FCC Registration Number (FRN)

NOTE: All Authorization Holders must have an FRN to file their response to the One-Time Information Collection.

• An FRN is the 10-digit number assigned to all individuals and entities that transact business with the Commission. An FRN must be provided any time an Authorization Holder submits an application in ICFS.

• If an Authorization Holder already has an FRN associated with a current Authorization File Number(s) in ICFS, the Authorization Holder must submit a response to the One-Time Information Collection using that specific FRN. The Authorization Holder should not obtain a new FRN, but confirm the FRN associated with its current Authorization File Number(s) in ICFS at: https://licensing.fcc.gov/myibfs/.

• If an Authorization Holder already has an FRN, but the FRN is not associated with a current Authorization File Number(s) in ICFS, the Authorization Holder must contact IBFSInfo@fcc.gov to add the FRN information to its current Authorization File Number(s) in ICFS. The Authorization Holder will need to supply its FRN and current Authorization File Number(s) in the email to FCC staff. The Authorization Holder can check whether its FRN is associated with its current Authorization File Number(s) in ICFS at: https://licensing.fcc.gov/myibfs/.

• If an Authorization Holder does not have an FRN, the Authorization Holder must obtain an FRN through the Commission Registration System (CORES) webpage at https://apps.fcc.gov/cores/userLogin.do. An entity that holds an International Section 214 Authorization should identify itself as an “Entity” in CORES. The Authorization Holder should then contact IBFSInfo@fcc.gov to add the FRN information to its current Authorization File Number(s) in ICFS. The Authorization Holder will need to supply its FRN and current Authorization File Number(s) in the email to FCC staff.

• If an Authorization Holder has more than one FRN, the Authorization Holder must identify each FRN and all of the current International Section 214 Authorization File Number(s) associated with each FRN in separate responses to the One-Time Information Collection. The Authorization Holder must file separate responses to the One-Time Information Collection for each FRN and the Authorization File Number(s) associated with that FRN.

6. Publication of the One-time Information Collection

• Responses to the One-Time Information Collection will be made publicly available in IB Docket No. 23-119 and associated with the Authorization Holder’s International Section 214 Authorization(s) in ICFS, except to the extent that any material or information is afforded confidential treatment.

7. Consequences for Failure to File a Timely Response

• The Commission is currently considering in a Notice of Proposed Rulemaking in IB Docket No. 23-119 whether to cancel the authorizations of carriers that fail to timely respond to the One-Time Information Collection and to impose forfeitures or other measures where a carrier fails to respond in a timely or complete manner.

8. Consequences for False Statements

• 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).

COMPLETING EACH QUESTION

IN THE ONE-TIME INFORMATION COLLECTION

Log In & Entity (or Registrant) Verification

(Questions 1 – 1.a.)

QUESTION 1

Enter the 10-digit FCC Registration Number (FRN) of the Authorization Holder. The Authorization Holder must enter the FRN that it used to log into the online system for the One-Time Information Collection.

• See pages 4-5 for further requirements regarding FRNs.

• Include all leading zeros when entering the FRN.

• For example, enter: 0012345678

QUESTION 1.a

Question 1.a will populate the following information associated with the FRN in CORES. The Authorization Holder must review this information for accuracy.

• Registration Date

• Last Updated

• Entity/Registrant Name

• Entity/Registrant Type

• If the Entity Name or Entity Type (or Registrant Name or Registrant Type) is incorrect, the Authorization Holder must correct the information by following these steps:

1. log out of the online filing system for the One-Time Information Collection;

2. log into CORES and update the information before continuing the One-Time Information Collection; and

(3) log back into the online filing system for the One-Time Information Collection in order for the updates to be applied in Question 1.a.

Identify All Current Authorization File Numbers Associated with FRN

(Questions 2 – 3.b)

QUESTION 2

Enter all of the Authorization Holder’s current International Section 214 Authorization File Numbers associated with this FRN. If an Authorization Holder has more than one FRN associated with its current International Section 214 Authorization File Number(s), it will need to file separate responses to the One-Time Information Collection for each FRN and the current Authorization File Number(s) associated with that FRN.

• The Authorization Holder must report all of the current Authorization File Numbers associated with the FRN identified in response to Question 1, but only the Authorization File Numbers associated with that FRN.

• See pages 4-5 for further requirements regarding FRNs.

The Authorization Holder may enter up to a maximum of 49 Authorization File Numbers.

• Leave blank any fields that are not applicable.

• Do not use dashes or spaces when entering the Authorization File Numbers.

• For example, enter: ITC2142023073100001 or ITCMOD2023073100001

QUESTION 2.a.

Respond with “Yes” or “No” as to whether the Authorization Holder has any additional Authorization File Numbers associated with this FRN.

QUESTION 2.b.

Enter all of the remaining Authorization File Numbers associated with this FRN.

• If the Authorization Holder has more than 49 current Authorization File Numbers associated with the FRN, the Authorization Holder must identify all of the remaining Authorization File Numbers in a text box provided in Question 2.b.

• Do not use dashes or spaces when entering the Authorization File Numbers.

• Separate the Authorization File Numbers with commas, and do not add a space after each comma.

• For example, enter: ITC2142023073100001,ITCMOD2023073100001

Authorization Holder’s Contact Information

(Questions 3 – 3.b)

QUESTION 3

Enter the Authorization Holder’s Contact Information.

• Enter the requested information for the Authorization Holder’s contact person who should receive any follow-up questions about the information submitted in the filing.

• Enter the Contact Representative’s first name, last name, company or organization, position/title, address, city, U.S. state/territory (2 letter abbreviation or “OU” for an international address), and zip code/postal code. For an international address, enter the international state/province.

QUESTION 3.a.

Select the country associated with the Contact Representative’s address.

QUESTION 3.b.

Enter the Contact Representative’s telephone number, telephone country code (if outside of the United States), email address, fax number (optional), and fax country code (if outside of the United States) (optional).

Authorizations Subject to a Mitigation Agreement

(Questions 4 – 5.b.)

QUESTION 4

Respond with “Yes” or “No” as to whether or not the Authorization Holder’s International Section 214 Authorization(s) is subject to a mitigation agreement (e.g., national security agreement, letter of agreement/assurance) entered into by the Authorization Holder with the Executive Branch agencies.

QUESTION 5

Enter all of the ICFS File Numbers that contain a copy of the mitigation agreement.

• The Authorization Holder may enter up to a maximum of 15 File Numbers.

• Do not use dashes or spaces when entering the File Number.

  • For example, enter:

    • ITC2142023073100001

    • ITCMOD2023073100001

    • ITCT/C2023073100001

    • ITCASG2023073100001

• Leave blank any fields that are not applicable.

• If the Authorization Holder’s International Section 214 Authorization(s) is subject to a mitigation agreement in an ISP-PDR File Number(s) in ICFS (in addition to or instead of an ITC File Number), the Authorization Holder must identify the ISP-PDR file number(s).

QUESTION 5.a.

Respond with “Yes” or “No” as to whether the Authorization Holder has any additional File Numbers that are subject to the mitigation agreement.

QUESTION 5.b.

Enter all of the remaining File Numbers that are subject to the mitigation agreement.

• If the Authorization Holder has more than 15 File Numbers that are subject to the mitigation agreement, the Authorization Holder must enter all of the remaining File Numbers in a text box provided in Question 5.b.

• Do not use dashes or spaces when entering the File Numbers.

• Separate the File Numbers with commas, and do not add a space after each comma.

• For example, enter: ITC2142023073100001,ITCMOD2023073100001,ITCT/C2023073100001,ITCASG2023073100001

Qualification for FCC’s Exemption from Completing Questions 9-14 of the Form

(Questions 6-8)

Authorization Holder Qualifies for an Exemption.

To qualify for the Exemption from completing Questions 9-14 of the form, the Authorization Holder must answer “yes” to Question 6 and then answer Questions 7-8, and Questions 15-17. For further information, refer to the FCC’s Public Notice with respect to the Exemption requirements (DA xx-xx).

Authorization Holder Does Not Qualify for an Exemption.

If the Authorization Holder DOES NOT qualify for the Exemption, it must answer “no” in Question 6, and then answer Question 9 concerning Reportable Foreign Ownership, and Questions 10-17.

QUESTION 6

The FCC has allowed an exemption from completing the latter portion (Questions 9-14) of this form if certain requirements are met. Respond with “Yes” or “No” as to whether the Authorization Holder qualifies for the Exemption from completing Questions 9-14 of this form.

To qualify for the Exemption:

(1) The Authorization Holder must have filed an application for an initial International Section 214 Authorization, modification, or substantial (not a pro forma filing) assignment or transfer of control of the authorization that was reviewed by the Executive Branch agencies and was granted by the Commission after XXXX xx, 2020 [[add date 3 years before the date of the filing deadline]]; and

(2) There are no reportable Foreign Interest Holders of the Authorization Holder other than those disclosed in the application (including any amendment), and there are no changes to the reportable Foreign Interest Holders disclosed in the application (including any amendment) as of XXXX xx, 2023 [[add date thirty (30) days prior to the date of the filing deadline for this One-Time Information Collection]].

• Type of Application(s). The type of applications that fulfill the Exemption are applications for:

• An initial International Section 214 Authorization;

• Modification of the Authorization;

• Substantial Assignment of the Authorization;

• Substantial Transfer of Control of the Authorization

NOTE: Pro forma assignment and transfer of control notifications do not fulfill the requirements for the Exemption. Section 63.24 of the Commission’s rules provides information with regard to substantial transactions and pro forma transactions.

• Three Year Timeframe. The application was reviewed by the Executive Branch agencies and was granted by the Commission within 3 years of [[add the date of the filing deadline]].

• No New Reportable Foreign Interest Holders or Other Changes. For purposes of this One-Time Information Collection, a “reportable Foreign Interest Holder” is a foreign individual(s) and/or entity(ies) (including a government organization) that directly and/or indirectly holds 10% or greater equity and/or voting interests, or a controlling interest, in an Authorization Holder (Reportable Foreign Ownership).

• To qualify for the Exemption, there must not be reportable Foreign Interest Holders other than those disclosed in the application (including any amendment).

• To qualify for the Exemption, there must be no changes to the reportable Foreign Interest Holders disclosed in the application (including any amendment), including but not limited to:

• No change in the reported citizenship(s), including dual or multiple citizenships, and/or place(s) of organization of any reportable Foreign Interest Holder;

• No removal of any reportable Foreign Interest Holder from an Authorization Holder’s chain of ownership; and

• No change in a reportable Foreign Interest Holder’s ownership interests to less than 10% equity and/or voting interests or less than a controlling interest.

QUESTION 7

Identify the File Number of the application that fulfills all of the requirements for the Exemption. If more than one application fulfills all of these requirements, provide the most recent File Number.

• If the Authorization Holder qualifies for the Exemption, the Authorization Holder must enter the ICFS File Number of the application that fulfills all of the requirements for the Exemption.

• Do not use dashes or spaces when entering the File Number.

• For example, enter: ITC2142023073100001, ITCMOD2023073100001, ITCT/C2023073100001, or ITCASG2023073100001

QUESTION 8

Aggregate and identify all of the citizenship(s) or place(s) of organization for every foreign individual and/or entity (including a government organization) that directly and/or indirectly holds 10% or greater equity and/or voting interests, or a controlling interest, in the Authorization Holder (Reportable Foreign Ownership).

• If the Authorization Holder qualifies for the Exemption, the Authorization Holder must identify the citizenship(s) or place(s) of organization for each of its reportable Foreign Interest Holders.

• The Authorization Holder must select all such countries of citizenships and/or places of organization from the list presented in Question 8. If there is more than one individual/entity that has a citizenship or place of organization from a given country, the country only needs to be selected once.

• Each Authorization Holder is required to identify Reportable Foreign Ownership where any interest holder (including a government organization) has a place of organization in or is a citizen of a country that meets the Department of Commerce’s definition of a “foreign adversary.” (FCC 23-28)

• A “foreign adversary” is defined in the Department of Commerce’s rule, 15 CFR § 7.4. These are: (1) The People’s Republic of China, including the Hong Kong Special Administrative Region (China), (2) Republic of Cuba (Cuba), (3) Islamic Republic of Iran (Iran), (4) Democratic People's Republic of Korea (North Korea), (5) Russian Federation (Russia), and (6) Venezuelan politician Nicolás Maduro (Maduro Regime).

• To identify Reportable Foreign Ownership that meets the Department of Commerce’s definition of “Venezuelan politician Nicolás Maduro (Maduro Regime),” an Authorization Holder can select “Maduro Regime” as a separate, additional response to “Country of Citizenship or Place of Organization.”

• An Authorization Holder must also identify Reportable Foreign Ownership from non-“foreign adversary” countries.

Identify Whether the Authorization Holder Has Reportable Foreign Ownership

(Question 9)

QUESTION 9

Respond with “Yes” or “No” as to whether the Authorization Holder has any 10% or greater direct or indirect Foreign Interest Holders that hold such equity and/or voting interests or any controlling interest (Reportable Foreign Ownership) as of [[x]] (i.e., thirty (30) days prior to the filing deadline for this One-Time Information Collection).

• All Authorization Holders that do not qualify for the Exemption must respond to Question 9.

• The information collection requirements are based on the requirements set forth in section 63.18(h) of the Commission’s rules, as amended.

• Section 63.18(h), as amended, requires “[t]he name, address, citizenship, and principal businesses of any individual or entity that directly or indirectly owns ten percent or more of the equity interests and/or voting interests, or a controlling interest, of the applicant, and the percentage of equity and/or voting interest owned by each of those entities (to the nearest one percent) . . . .”

  • Order at para. 18 & n.73; Process Reform for Executive Branch Review of Certain FCC Applications and Petitions Involving Foreign Ownership, IB Docket No. 16-155, Report and Order, 35 FCC Rcd 10927, 10985, Appx. B, para. 11 (2020); Process Reform for Executive Branch Review of Certain FCC Applications and Petitions Involving Foreign Ownership, IB Docket No. 16-155, Erratum, 35 FCC Rcd 13164, 13173, para. 11 (2020).

• If the Authorization Holder responds “No” in Question 9, the Authorization Holder must then complete Questions 14-17.

Reportable Foreign Ownership

(Questions 9.a – 13)

QUESTION 9.a.

Select the number of Foreign Interest Holders that directly hold 10% or greater equity and/or voting interests, or a controlling interest, in the Authorization Holder.

• If the Authorization Holder has one or more foreign individual(s) and/or entity(ies) (including a government organization) that directly and/or indirectly hold a Reportable Foreign Ownership interest, the Authorization Holder must complete Questions 10-11 for each reportable Foreign Interest Holder (up to 100 Foreign Interest Holders).

QUESTION 10

Identify each foreign individual and/or entity (including a government organization) that directly and/or indirectly holds 10% or greater equity and/or voting interests, or a controlling interest, in the Authorization Holder (Reportable Foreign Ownership) as of [[x]] (i.e., thirty (30) days prior to the filing deadline).

• Enter the Legal Name of Foreign Interest Holder, Percentage of Equity Interests Held (To the nearest one percent), Percentage of Voting Interests Held (To the nearest one percent), and Description of Controlling Interests (if applicable).

• The Authorization Holder must complete each field.

• If correct, the Authorization Holder should enter “0” for Percentage of Equity Interests Held (To the nearest one percent), or Percentage of Voting Interests Held (To the nearest one percent).

• If correct, the Authorization Holder should enter “None” for Description of Controlling Interests.

• Each Authorization Holder is required to identify Reportable Foreign Ownership where any interest holder (including a government organization) has a place of organization in (for entities) or is a citizen of (for individuals) a country that meets the Department of Commerce’s definition of a “foreign adversary.” (FCC 23-28)

• A “foreign adversary” is defined in the Department of Commerce’s rule, 15 CFR § 7.4. These are: (1) The People’s Republic of China, including the Hong Kong Special Administrative Region (China), (2) Republic of Cuba (Cuba), (3) Islamic Republic of Iran (Iran), (4) Democratic People's Republic of Korea (North Korea), (5) Russian Federation (Russia), and (6) Venezuelan politician Nicolás Maduro (Maduro Regime).

• To identify Reportable Foreign Ownership that meets the Department of Commerce’s definition of “Venezuelan politician Nicolás Maduro (Maduro Regime),” an Authorization Holder can select “Maduro Regime” as a separate, additional response to “Country of Citizenship or Place of Organization” in Question 11.

• An Authorization Holder must also identify Reportable Foreign Ownership from non-“foreign adversary” countries.

QUESTION 11

Identify all of the Countries of Citizenship or Places of Organization of the Foreign Interest Holder, including the United States.

• For each reportable Foreign Interest Holder, the Authorization Holder must select all of the countries of citizenship and/or places of organization of the Foreign Interest Holder from the list presented in Question 11.

• Dual or More Citizenships. The Authorization Holder must disclose whether any interest holder has dual or more citizenships and identify all countries where citizenship is held. This requirement applies to United States citizens who hold dual citizenship or multiple citizenships and foreign persons who are citizens of two or more countries.

• To identify Reportable Foreign Ownership that meets the Department of Commerce’s definition of “Venezuelan politician Nicolás Maduro (Maduro Regime),” an Authorization Holder can select “Maduro Regime” as a separate, additional response to “Country of Citizenship or Place of Organization.”

QUESTION 12

Respond with “Yes” or “No” as to whether the Authorization Holder has any additional Foreign Interest Holders that directly and/or indirectly hold 10% or greater equity and/or voting interests, or a controlling interest, in the Authorization Holder.

• If the Authorization Holder selects yes, to signify it has more than 100 reportable Foreign Interest Holders, the Authorization Holder must provide the information about all of its remaining Foreign Interest Holders in response to Question 13.

QUESTION 13

Identify all of the remaining foreign individual(s) and/or entity(ies) (including a government organization) that directly and/or indirectly hold 10% or greater equity and/or voting interests, or a controlling interest, in the Authorization Holder (Reportable Foreign Ownership) as of [[x]] (i.e., thirty (30) days prior to the filing deadline), beyond the 100 Foreign Interest Holders identified by the Authorization Holder in its response to Questions 10-11.

• If an Authorization Holder has more than 100 Foreign Interest Holders, the Authorization Holder must provide the information required in Questions 10 and 11 for all of the remaining Foreign Interest Holders by utilizing the .csv attachment available on the FAQs webpage [[insert link]].

• The Authorization Holder must download the .csv attachment, respond to all of the questions in the .csv attachment (based on Questions 10 and 11) for each of the remaining Foreign Interest Holders, and upload the completed attachment to the online filing system for the One-Time Information Collection.

No Reportable Foreign Ownership Certification

(Question 14)

QUESTION 14

If applicable, the Authorization Holder must certify that it does not have 10% or greater direct or indirect Foreign Interest Holders that hold such equity and/or voting interests or any controlling interest (Reportable Foreign Ownership) in the Authorization Holder as of [[x]] (i.e., thirty (30) days prior to the filing deadline).

• An Authorization Holder that has no Reportable Foreign Ownership must certify to the truth and accuracy of this information.

Certification

(Questions 15 - 17.b.)

QUESTION 15

An officer of the Authorization Holder must certify to the truth and accuracy of all information provided in response to the One-Time Information Collection.

• An officer of the Authorization Holder is, for example, a corporate officer, managing partner, or sole proprietor.

QUESTION 16

Enter the Certifying Official’s Signature.

• For purposes of this filing, the entry of the official’s name shall constitute that official’s electronic signature to this certification. The signature certifies that he/she has examined the filing and that, to the best of his/her knowledge, information and belief, all statements of fact contained in the filing are true and correct.

• Persons making willful false statements can be punished by fine or imprisonment under the Communications Act. 47 U.S.C. § 220(e).

QUESTION 17

Enter the Certifying Official’s first name, middle name (optional), last name, position/title, company or organization, address, city, U.S. state/territory (2 letter abbreviation or “OU” for an international address), and zip code/postal code. For an international address, enter the international state/province.

QUESTION 17.a.

Select the country associated with the Certifying Official’s address.

QUESTION 17.b.

Enter the Certifying Official’s telephone number, telephone country code (if outside of the United States), email address, fax number (optional), and fax country code (if outside of the United States) (optional). Enter the date of the Certifying Official’s certification.

FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT

The public reporting for this collection of information is estimated to average 6 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the required data, and completing and reviewing the collection of information.  If you have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you, please write to the Federal Communications Commission, AMD−PERM, Paperwork Reduction Project (3060−1308), Washington, DC 20554.  We will also accept your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to PRA@fcc.gov.  PLEASE DO NOT SEND COMPLETED FORMS 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 OMB control number or if we fail to provide you with this notice.  This collection has been assigned an OMB control number of 3060-1308.

THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104−13, OCTOBER 1, 1995, 44 U.S.C. SECTION 3507.