All requests for Special Temporary Authority and other non-application-form (e.g., letter) requests must include the Anti-Drug Abuse Act Certification set forth below.  The certification may be included in the request itself or attached to the request (you may print and use this page as an attachment).  It must be signed by an officer of the corporation or organization.

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.)



For more information on AM and FM radio broadcasting, please visit the Audio Division website, and the Broadcast Radio Links page.

For more information on Television broadcasting, please visit the Video Division website.

FCC > Media Bureau > Audio Division, (202) 418-2700, and Video Division, (202) 418-1600.

 

Bureau/Office: 

Updated: 
Sunday, December 13, 2015