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Licensee/Permittee Information | ||||||
1. | Legal Name of the Licensee/Permittee STATE BOARD OF EDUCATION, STATE OF IDAHO |
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Mailing Address 1455 N. ORCHARD STREET ATTN: RICHARD VAN GENDEREN |
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City BOISE |
State or Country (if foreign address) ID |
ZIP Code 83706 - 2239 |
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Telephone Number (include area code) 2083737220 |
E-Mail Address (if available) DUTCH@IDAHOPTV.ORG |
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Station / Facility Information | ||||||
2. | FCC Registration Number 0001631738 |
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Call Sign KISU-TV |
Facility ID Number 62430 |
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Community of License: City POCATELLO |
State ID |
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3. | Currently Assigned Channels: | |||||
a. DTV Channel: 17 ![]() |
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b. NTSC Channel: 10 ![]() |
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Contact Information (if different from licensee/permittee) | ||||||
4. | Contact Representative ANNE GOODWIN CRUMP |
Firm or Company Name IDAHO PUBLIC TELEVISION |
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Mailing Address 1455 N. ORCHARD STREET |
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City BOISE |
State or Country (if foreign address) ID |
ZIP Code 83706 - 2239 |
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Telephone Number (include area code) 7038120400 |
E-Mail Address (if available) CRUMP@FHHLAW.COM |
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Purpose of Form: | ||||||
5. |
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1. | Channel Election: (SELECT ONE) |
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International Coordination. | ||||
2 | Is the licensee/permittee electing a channel that is subject to a pending international coordination issue?
If yes, licensee/permittee must attach an explanation as an Exhibit to this form. |
![]() ![]() [Exhibit 1] |
Section III
I certify that the statements in this form are true, complete, and correct to the best of my knowledge and belief, and are made in good faith. I acknowledge that all certifications and attached Exhibits are considered material representations. I hereby waive any claim to the use of any particular frequency as against the regulatory power of the United States because of the previous use of the same, whether by license or otherwise, and request an authorization in accordance with this election form. (See Section 304 of the Communications Act of 1934, as amended.)
Typed or Printed Name of Person Signing PETER W. MORRILL |
Typed or Printed Title of Person Signing GENERAL MANAGER |
Signature |
Date 01/03/2005 |
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).