| Call Letters: |
| Facility ID#: |
| City of License: |
| Contact Name: |
| Street Address: |
| City: |
| State: |
| Zip: |
| Mailing Address (if different): |
| City: |
| State: |
| Zip: |
| Phone: |
| FAX: |
| Email: |
| Dates when station will NOT be available or prepared for inspection: |
By authorizing this inspection, you agree that your payment and/or signature constitutes a contract with ABA/Larry Wilkins for inspection detailed above and agree to pay any and all travel expenses for the inspection involved. You understand that ABA will keep no file on the inspection. All details will be strictly between the inspector and the inspected station. Further, you understand that the exemption from FCC inspections is from random inspections and does not apply if a complaint is filed against your station(s) or in certain other situations.
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DTV or Analog TV
ABA Member ($0)
Non-member ($450)Second DTV or Analog TV same location
ABA Member ($0)
Non-member ($525)FM or Non-directional AM
ABA member ($0)
Non-member ($600)Additional FM or Non-directional AM same location ABA member ($0 each) –
How many? Additional FM or Non-directional AM same location Non-member ($300 each) –
How many? Directional AM
ABA member ($0)
Non-member ($700) |
| Person Authorizing Inspection: |
| Today’s Date: |
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