|
Licensee/Permittee Information | ||||||
1. | Legal Name of the Licensee/Permittee THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ALABAMA |
|||||
Mailing Address BOX 870150 |
||||||
City TUSCALOOSA |
State or Country (if foreign address) AL |
ZIP Code 35487 - |
||||
Telephone Number (include area code) 2053488622 |
E-Mail Address (if available) DAVE@ALABAMATV.ORG |
|||||
Station / Facility Information | ||||||
2. | FCC Registration Number 0001749688 |
|||||
Call Sign WLDM |
Facility ID Number 77496 |
|||||
Community of License: City TUSCALOOSA |
State AL |
|||||
3. | Currently Assigned Channels: | |||||
a. DTV Channel: Not Applicable | ||||||
b. NTSC Channel: 23 Not Applicable | ||||||
Contact Information (if different from licensee/permittee) | ||||||
4. | Contact Representative M. SCOTT JOHNSON |
Firm or Company Name FLETCHER, HEALD & HILDRETH, P.L.C. |
||||
Mailing Address 1300 NORTH 17TH STREET 11TH FLOOR |
||||||
City ARLINGTON |
State or Country (if foreign address) VA |
ZIP Code 22209 - |
||||
Telephone Number (include area code) 7038120474 |
E-Mail Address (if available) SJOHNSON@FHHLAW.COM |
|||||
Purpose of Form: | ||||||
5. |
|
1. | Channel Election: (SELECT ONE) |
|||
|
||||
|
||||
|
||||
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. |
Yes No [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 DAVID M. BAUGHN |
Typed or Printed Title of Person Signing DIRECTOR OF ENGINEERING |
Signature |
Date 02/10/2005 |
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).