BS Print Page 1 of8 l'\A b \ -- 01 Federal Communications Commission Approved by OMB FOR FCC USE ONLY Washington, D.C. 20554 3060-0027 (July 2011) FCC 301 FOR COMMISSION USE ONLY APPLICATION FOR CONSTRUCTION PERMIT FOR ALE NO. COMMERCIAL BROADCAST STATION BPH - 20110819ABZ Read INSTRUCTIONS Before Filling Out Fonn Section I - General Information l. Legal Name of the Applicant BASIN MEDIACTIVE, LLC Mailing Address 404 MAIN STREET SUlTE4 City State or Country (if foreign address) I I~ Code KLAMATH FALLS OR 97601- Telephone Number (include area code) E-Mail Address (if available) 5418828833 [email protected] FCC Registration Number: ~ Call Sign Facility ID Number 0020563748 KYSF 3462 2. Contact Representative (if other than Applicant) Finn or Company Name DAWN M. SCIARRINO, ESQ. SCIARRINO & SHUBERT, PLLC Mailing Address 5425 TREE LINE DRIVE City State or Country (if foreign address) I I~ Code CENTREVILLE VA 20120- Telephone Number (include area code) E-Mail Address (if available) 2023509658 DA [email protected] 3. [f this application has been submitted without a fee, indicate reason for fee exemption (see 47 C.F.R. Section 1.1114): r Governmental Entity r Other (" N/A (Fee Required) 4. Application Purpose (" New station r. New Station with Petition for Rulemaking or Counterproposal to Amend FM Table of Allotments r Major Modification of construction permit r Major Change in licensed facility r Minor Modification of construction pennit \e Minor Change in licensed facility (" Major Amendment to pending application r Minor Amendment to pending application (a) File number of original construction pennit: -rNA (b) Service Type: r AM \e FM C TV r DTV C DTS (c) DTV Type: r. Pre-Transition r Post-Transition (" Both (d) Community of License: City: BONANZA State: OR (e)Facility Type \e Main (" Auxiliary If an amendment, submit as an Exhibit a listing by [Exhibit 1] Section and Question Number the portions of the pending https:lIlicensing.fcc.gov/cgi-bin/ws.exe/prod/cdbs/fonns/prod/cdbsmenu.hts?context=25&... 1130/2012 SPrint Page 2 of 8 Uapplication that are being revi ed. NOTE: In addition to the information called for in this section, an explanatory exhibit providing full particulars must be submitted for each question for which a "No" response is provided. Section II - Legal . Certification. Applicant certifies that it has answered each question in this application based r. Yes r No ~n its review of the application instructions and worksheets. Applicant further certifies that where it has made an affinnative certification below. this certification constitutes its jrepre entation that the application satisfies each of the pertinent standards and criteria set ~ forth in the application instructions and worksheets. 12. Parti to the Application. Ia. List the applicant. and. if other than a natural person. its officers. directors. stockholders with attributable interests. non-insulated partners and/or members. If a corporation or partnership holds an attributable interest in the applicant. list separately its officers. directors, stockholders with attributable interests, non-insulated partners and/or members. Create a separate row for each individual or entity. Attach additional pages if necessary. (I) Name and address of the applicant and each party to the (2) Citizenship. application holding an attributable interest (if other than (3) Positional Interest: Officer, director, general individual also show name, address and citizenship of natural partner, limited partner, LLC member, person authorized to vote the stock or holding the attributable investor/creditor attributable under the interest). List the applicant first, officers next, then directors Commission's equity/debt plus standard, etc. and, thereafter, remaining stockholders and other entities with (4) Percentage of votes. attributable interests, and partners. (5) Percentage of total assets (equity plus debt). [Enter Parties/Owners Infonnation] b. Applicant certifies that equity and financial interests not set forth above are non­ r Ye r No attributable. r N/A See Explanation in [Eldlibit 2] Fl Other Authorizations. List call signs. locations, and facility identifiers of all other broadcast I r N/A usta tions in which applicant or any party to the application has an attributable interest. (Exhibi13] ~. Multiple Ownership. n. I the applicant or any party to the application the holder of an attributable radio joint rYes r. No Is ale agreement or an attributable radio or television time brokerage agreement in the isame market as the station subject to this application? [Exhibit 4] If "YES," radio applicants must submit as an Exhibit a copy of each such agreement for radio stations. ~~======================================~?=~==~==9 b. Appl icant certifies that the proposed facility complies with the Commission's multiple r. Yes r No ownership rules and cross-ownership rules. Radio applicants only: If "Yes," submit an Exhibit providing infonnation regarding the [Exhibit 5] market, broadcast station(s), and other infonnation necessary to demonstrate compliance with 47 C.F.R. § 73.3555(a). https:lIlicensing.fcc.gov/cgi-binlws.exe/prod/cdbs/fonns/prod/cdbsmenu.hts?context=25&... 1/30/2012 , CDBS Print Page 3 of 8 All Applicants: If "No," submit as an Exhibit a detailed explanation in support of an exemption from, or waiver of, 47 C.PR § 73.3555. I I ~c. Applicant certifies that the proposed facility: r. Yes r No (1) does not present an issue under the Commission's policies relating to media interests See Explanation in of immediate family members; [Exhibit 6] (2) complies with the Commission's policies relating to future ownership interests; and (3) complies with the Commission's restrictions relating to the insulation and non- participation of non-party investors and creditors. '== d. Does the Applicant claim status as an "eligible entity," that is, an entity that qualifies as a rYes r. No Ismail business under the Small Business Administration's size standards for its industry See Explanation in grouping (as set forth in 13 C.P.R. § 121-201), and holds: [Exhibit 7] (1) 30 percent or more of the stock or partnership interests and more than 50 percent of the voting power of the corporation or partnership that will own the media outlet; or (2) 15 percent or more of the stock or partnership interests and more than 50 percent of the voting power of the corporation or partnership that will own the media outlet, provided that no other person or entity owns or controls more than 25 percent of the outstanding stock or partnership interests; or (3) more than 50 percent of the voting power of the corporation that will own the media outlet (if such corporation is a publicly traded company)? All applicants: If "Yes," submit as an Exhibit a detailed showing demonstrating proof of status as an eligible entity. := r5. ICharacter Issues. Applicant certifies that neither applicant nor any party to the application rYes r No Ihas or has had any interest in or connection with: a. any broadcast application in any proceeding where character issues were left unresolved See Explanation in or were resolved adversely against the applicant or party to the application; or [Exhibit 8] b. any pending broadcast application in which character issues have been raised. ~ ~lAdV.rs. Findmgs. AppHe,,", ce";fi", tha'. with respec' '0 the applie,,"' and any party '0 'he rYes r No japplication, no adverse finding has been made, nor has an adverse final action been taken by lan y court or administrative body in a civil or criminal proceeding brought under the provisions of any law related to any of the following: any felony; mass media-related antilrUsi See Explanation in [Exhibit 9] lor unfair competilion: fraudulent statements to another government unit: or discrimination. ~eD Ownership and Control. Applicant certifies that it complies with the provisions of rYes r No ~eclion 310 of the Communications Act of 1934, as amended, relating to interests of aliens land foreign governments. See Explanation in 0 [Exhibit 101 ~ ",og, am Senoke CenfficatiOD. AppHe,,"' certifi", tha' it i, eogni,an, of aod will comply r Ye r No Iwith its obligations as a commission licensee to present a program service responsive to the issues of oublic concern facin!!: the station's communitv of license and service area. I I ILocai Public Notice. Applicant certifies that it has or will comply with the public notice rYes (' No [] ~eQuirements of 47 C.P.R. Section 73.3580. ;:= I I 10. lAuction Authorization. If the application is being submitted to obtain a construction permit rYes r No for which the applicant was the winning bidder in an auction, then the applicant certifies, N/A jpur uant to 47 C.PR Section 73.5005(a), that it has attached an exhibit containing the r information required by 47 C.P.R. Sections 1.2107(d), 1.211O(i), 1.2112(a) and 1.2112(b), if iapplicable. [Exhibit 11] L........ IAn exhibit is required unJess this question is inapplicable. DIADti.Drug Abuse Act CemficatioD. AppHe,,"' certifi", tha' neithe' appHean' no, any party r. Ye r No o the application is subject to denial of federal benefits pursuant to Section 5301 of the Anti- Iorug Abuse Act of 1988. 21 U.S.c. Section 862. I I f21fquaJ Employment Opportunity (EEO). If the applicant proposes to employ five or more I ('" Yes ('" No I https:lIlicensing.fcc.gov/cgi-binlws.exe/prodlcdbs/fonns/prodlcdbsmenu.hts ?context=25&... 1/30/2012 · CnBS Print Page 4 of8 Ulrun-time employees, applicant certifies that it is filing simultaneously with this application a l N/A Model EEO Program Report on FCC Fonn 396-A. I I 13. ~e tition for RulemakinglCounterproposai to Add New FM Channel to FM Table of l Yes l No ~ otm en ts . If the application is being submitted concurrently with a Petition for Rulemakjng r.