This certification MUST BE INCLUDED with requests for Special Temporary Authority and other non-application-form requests.

This certification must be signed by an officer of the corporation or organization.

This form does not have to be used, but the certification must be made as set forth below. This certification is already printed in FCC application forms and so need not be included as an attachment to an FCC application form.

Answer YES if all parties to the application are in compliance with Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. Section 862, the federal law which provides federal and state court judges the discretion to deny federal benefits to individuals convicted of offenses consisting of the distribution of controlled substances. For a definition of "party" for these purposes, see 47 C.F.R. Section 1.2002(b). See also Amendment of Part 1 of the Commission's Rules to Implement Section 5301 of the Anti-Drug Abuse Act of 1988, 6 FCC Rcd 7551, 57 Fed. Reg. 00186 (1991). ____________ YES         NO ____________ By checking yes, the applicant certifies that, in the case of an individual applicant, he or she is not subject to a denial of federal benefits that includes FCC benefits pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. 862, or, in the case of a non-individual applicant (e.g., corporation, partnership or other unincorporated association), no party to the application is subject to a denial of federal benefits that includes FCC benefits pursuant to that section. For the definition of a party for these purposes, see 47 C.F.R. Section 1.2002(b). I certify that the statements made in this application are true, complete, and correct to the best of my knowledge and belief, and are made in good faith. ___________________________________________ Name of Applicant ___________________________________________ Signature and Date ___________________________________________ Printed Name of Person Signing ___________________________________________ Title ___________________________________________ Call Sign of Station and Type of Request (Special Temporary Authority, etc.)