Form 159/442 Payment Page/Check

0186-EX-PL-2000 Text Documents

Denali Valley Mines LLC

2003-08-22ELS_62599

READ INSTRUCTIONS CAREFULLY _ APPROVED BY OomMB :oso.osaif BEFORE PROCEEDING FEDERAL COMMUNICATIONS COMMISSION REMITTANCE ADVICE [TP"*"*___[4435 (1) LOCKBOX # msems _ ue J2 Etrom onter name ex as it appears on your tard} Zhomp s on 284 _Deswail /4//7 A.ntesLt ) CITY 17) STATE 18) 7P COOE waAs / flg ) DAVTIME TELEPMONE NUMBE R {lnclude sree code) MnsK9 1101 COUNTAMY COOE (f net in U.$A.) 496 97 0 — —@)/"7 4 fo IF PAYER NAME AND THE APPLICANT NAME ARE DIFFERENT, COMPLETE SECTION B IF MORE THAN ONE APPLICANT, USE CONTINUATION SHEETS (FORM 159—C) 119 { € . onter mtrme an appeors on yeur card) zmHS _A GCGoU : | [17) STREE T ADDRESS LINE NO. i K131 STREET AOORESS LINE NO. 2 F\‘I CITY (15) STATE (16) ZiP COOE [17) BAYTTIME TELEPHONE NUMBER (inclade sres code) (18) COUWNTRY CODE (d not in U.$.A.) COMPLETE SECTION C FOR EACH SERVICE, IF MORE BOXES ARE NEEDED, USE CONTINUATION SHEE'I;S (FORM 159—C) ) D l,':) m"' , } Inass—ormememmunacemmnenee [3 A ds s s (?3A) FcC cone i TearFce c0bd€ KipBrrcc cact siomwothe® o (208) PAYMENT TYPE CODE (PTC) ie ovantit?y farr®) ree OR (PTC) N BLOCK 200 |___| | : h2381 FCC CODE 1 [248) FCC CODE 3 neptmnetuntimmmmm [19C);FCC CALL SIGNOTHER iD (20C) PAYMENT TYPE CODE (PTC) 121C) QuaANTITY [(2C) FEE OUE FOR (PTC) iN BLOCK 20C ONLY k23C| FCC CODE 1 l _ | s §24C)FCC CODE 2 — aumemnc p—mommsunmmmssent [19D; 5CC CALL SIGNOTHER i0 . {200) PAYMENT TYPE CODE {PTC) (21D) QUANTITY 1(«20) FEE DUE FOR (PTC) IN BLOCK 200 Y 230) FCC CODE 1 | | | s (24Dj; FCC COODE 2 . — mmpomenmenmetes euaitianmntiinommetintammntDemenimyeipenpmmnatnpnnptpeirtantetoommmnttienaniieimsanemeny ® —& J

Anproved by OMB FEDERA. COMMUNICATIONS COMMISsION i :: 3350—0085 ( use , Ebxp~es 9/20,/98 FCC FORM 442 ;"‘"%CC/ME“Q“ JUL 03 2000 APPLICATION FOR NEW OR MODIFIEED RADIOG STATION AUTHORIZATION UNDER PART 5& OF FCC RULES — EXPERIMENTAL RADIO SERAYICE (CTHER THAN BRoaADcaST) sECT i on _i APPLICANT NAME {Last firs, middle Inittal) Hompson_KEVIN D. PBA Dennli Vniley minesLLC MAILING ADDRLSS (Line ; {Maximum 3# characters ~ ze"er io lastruction (2) on reverse of form) PO. Box S7553Y4 MALINC ADDREZS (CLine 2 (|f required) (Maximum 05 chracters M uIPT?7 wsi4/+A "TATE OR COUNTRY (GUfF foreign address) 2P CODE CALL SIGN OR FILE NUMBARR M4inzkA 4 176J7 7 trier in Colm (A) Mha correct Fre Tyas Zode fo" the service you we appyng for, Fee Typoe Sodes ma»y ze fowx in PRC "ae F ing Guides. Emier in So‘urin ) ‘ne Foce Multgile, !f izspfcable. Enter in Cokrm (C) the result cbtafted ‘rom r—ult#y: 93 the vAue C1 the Fee Type Sode in Colker {2) by the rumbe~ en‘eeed in Cojuytm (B), if ay. (A) _(® [€C) B i FEE TYPE CI08 UEEE MULYT FEE DUCE FoR FEE TVPE ht iX rmh%‘”/fi C008E N COLUM® (a} 1 Egia:p;{ E%AE j * 45. °2 | s EC T | ON | j To be usei 7* when yoy are recueasting concyrren‘t actions whicht resut in a vh FEE TYVPE(A) CcoOE rsq.rernent to iss more than one "se 1,peo Code. (8 1G) PE MATPLE FEE DUE FOR FES TYPE U requbead CODK IN COLUMA lA} (2) % p— (3) ; # 14) , }i % {6) § aADD ALL AMOUNTS SHOWN iN COLUMN C, LINESs [» "~HROUGH (%), AND ENTER mf TOTAL MHERE TH$ AMOUNT BMAOULD TQUAL YOUR ENCLOSED REMTTANCE. * This larm has beeth MANOrRAG 1!5r rearodjusiion. FCC F3rm 422

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Document Created: 2003-08-22 09:46:09
Document Modified: 2003-08-22 09:46:09
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