Application Form

This document pretains to DNC-NEW-20170216-00001 for New Application on a Data Network Code filing.

DATA NETWORK IDENTIFICATION CODE FILING FOR OFFICIAL USE ONLY

APPLICANT INFORMATION

Enter a description of this application to identify it on the main menu:

02/05/2017

1. Applicant Name: marie davis Phone Number: -- DBA Name: Drake Fax Number: Street: 280 commerce cir E-Mail: [email protected] City: sacramento State: CA Country: USA Zipcode: 95814 - Attention: Aubrey graham
2. Contact Name: Aubrey Graham Phone Number: -- Company: Fax Number: Street: 280 commerce cir E-Mail: [email protected] City: sacramento State: CA Country: USA Zipcode: 95814 - Attention: Relationship: Same
3. Type Request New Reassign Note: Please submit any needed attachments for the given request type: Attachment 1: Document Attachment 2: Document Attachment 3: Document	4. Reassign Reason: From Company: To Company: From Code: To Code:
5. Network Name KSFM
6. International Service FCC
7. Action Requested Distribution of funds for CBS broadcasting.
8. Code assignments held in excess of 18 months without implementation must be returned to this Administrator for reassignment. Unless this office is specifically notified of the actual implementation of assignments, it will be assumed that those implementations did not occur and such assignments will be available for reassignment. I have read and understand these conditions. Yes No
9. I am aware that all DNIC assignments are provisional and that nobody has a property right in a DNIC. I am aware that the Commision may take an assigned DNIC and reassign it to another person. Yes No
10. I certify that all necessary local, state, and federal authorizations needed have been obtained. Yes No
WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND / OR IMPRISONMENT (U.S. Code, Title 18, Section 1001), AND/OR REVOCATION OF ANY STATION AUTHORIZATION (U.S. Code, Title 47, Section 312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, Section 503).