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Application to renew a broadcasting licence for a distribution undertaking - Form 123General instructions
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Canadian Radio-television and Telecommunications CommissionForm 123 - Application to renew a broadcasting licence for a distribution undertaking1. General information
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| Location of undertaking: ____________________________________________ |
| TYPE OF UNDERTAKING | NUMBER OF SUBSCRIBERS | |||
| Radiocommunication (off-air): |
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| MDS | Class 1 ( ) | Class 2 ( ) | Class 3 ( ) | |
| LMCS | Class 1 ( ) | Class 2 ( ) | Class 3 ( ) | |
| MTV (unscrambled) ( ) | ||||
| STV (scrambled) ( ) | ||||
| Satellite: |
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| DTH ( ) | ||||
| Other ( ) Specify: |
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1.1 |
Identification of licensee Name: Address: Fax: E-mail: Contact person representing the licensee |
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| 1.2 |
Appointment of agent
I, _________________________, the licensee, hereby appoint _____________________ as my agent for and on my behalf and in my name to sign, file and complete (if necessary) an application with the Canadian Radio-television and Telecommunications Commission and to sign and file a reply with respect thereto and I do hereby ratify, confirm, and adopt as my own act, such application and all replies made thereto. Date: |
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| 1.3 |
Declaration of the licensee or its appointed agent |
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| I, ___________________________________ SOLEMNLY DECLARE THAT: |
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| a) |
I am the ___________________________ (representative/appointed agent) of the licensee named in this Application Brief and as such have knowledge of all matters declared therein. |
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| b) |
The statements made in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) to the best of my knowledge and belief true in all respects. |
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| c) |
The opinions and estimates given in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) based on facts as known to me. |
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| d) |
I have examined the provisions of the Broadcasting Act and the broadcasting regulations relevant to this application. |
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And I have signed
Signature: Date: Witnessed by Signature: Name (Printed): Date: At: |
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| 1.4 |
Location(s) where the application may be examined
Set out the applicant’s website address or, if the application is not posted on their website, the email address where an electronic copy of the application may be requested: Website: Email: |
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| 1.5 |
Compliance
The undertaking is being operated in compliance, over the licence term, with the provisions of its licence, the Broadcasting Act, and all applicable regulations of the CRTC. |
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| YES ( ) |
NO ( ) |
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If NO, provide the full details of any non-compliance during the licence term, including the reasons, any remedial action and, where applicable, the period of time expected before the undertaking is operating in compliance.
Date: At: Signature of Licensee or its appointed agent: |
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The Canadian Radio-television and Telecommunications Commission Rules of Practice and Procedure allow an interested person to request that the Commission exercise a power under the Rules of Procedure or change the Rules of Procedure for a specific proceeding (sections 5 and 7). This is generally called a procedural request. You may consult the Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and the Guidelines on the CRTC Rules of Practice and Procedure, Broadcasting and Telecom Information Bulletin CRTC 2010-959, 23 December 2010, for more information.
Is the applicant requesting that the Commission make an exception to its Rules of Procedure in the treatment of this application?
Yes ( ) No ( )
If yes, please indicate which section of the Rules of Procedure you wish to vary, and provide a detailed rationale as to why this request should be granted :
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Definitions:
(1) Voting shares: The shares to which are attached one or more votes, and includes securities that are convertible into such shares at all times at the option of the holder. |
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| 2.1 |
For the licensee, complete the following tables providing: |
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| a) |
A list of the directors and officers, including the Chief Executive Officer. |
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| Name of the corporation for which the following table pertains: | ||||
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DIRECTORS AND OFFICERS |
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Name |
Complete Home |
Citizenship |
Directors: |
Officers: |
b) |
A list of shareholders holding 10% or more of the voting shares(1), of the voting rights (when different from the voting shares), and of the Common(2) (participating) shares, by class of shares. |
| Name of the corporation for which the following table pertains: | ||||||||
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CAPITAL STRUCTURE AND SHAREHOLDERS |
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Shares/ |
Participating |
Votes |
Authorized |
Issued |
Name of Shareholders |
No. |
% of |
Canadian |
c) |
A breakdown between Canadian and non-Canadian of the remaining shares not accounted for in b), by class of shares. |
| Name of the corporation for which the following table pertains: | ||||
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Class of |
Shareholders |
Total Number of |
% of |
Canadian |
If all of the ownership information requested in questions 2.2 and 2.3 has already been submitted to the Commission within the last 12 months and is still current, complete the following: |
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| . |
The application number or the date where this information was last supplied: |
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| . |
Go to section 3. |
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| 2.2 |
Complete the following tables for each corporation holding, directly and/or indirectly, 20% or more of the voting interest (shares and/or votes) of the licensee: |
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| a) |
A list of the directors and officers of the corporation, including the Chief Executive Officer. |
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| Name of the corporation for which the following table pertains: | ||||
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DIRECTORS AND OFFICERS |
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Name |
Complete Home |
Citizenship |
Directors: |
Officers: |
b) |
A list of shareholders holding 10% or more of the voting shares(1), of the voting rights (when different from the voting shares), and of the Common(2) (participating) shares, by class of shares. |
| Name of the corporation for which the following table pertains: | ||||||||
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CAPITAL STRUCTURE AND SHAREHOLDERS |
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Shares/ |
Participating |
Votes |
Authorized |
Issued |
Name of Shareholders |
No. |
% of |
Canadian |
c) |
A breakdown between Canadian and non-Canadian of the remaining shares not accounted for in b), by class of shares. |
| Name of the corporation for which the following table pertains: | ||||
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Class of |
Shareholders |
Total Number of |
% of |
Canadian |
2.3 |
Complete the same tables as in 2.2 for each corporation holding, directly and/or indirectly, 20% or more of the voting interest (shares and/or votes) of the corporations in 2.2 b), and for any corporation forming part of their ownership chain. |
| Supporting document to be appended: |
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| APPENDIX 2A |
A copy of all changes or amendments to the constituting documents (for example, Letters Patent, By-Laws, etc.) of the licensee and of the corporations listed in 2.2 and 2.3, that are not already filed with the Commission. |
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3. Industry consolidation and cross-media ownership
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| 3.1 |
Provide a list of all entities involved in any of the areas listed below, for which any investment (equity and/or debt securities) is held by the licensee, a corporation which directly or indirectly controls the licensee and any shareholder holding 20% or more of the voting shares and/or rights of the licensee. |
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| a) |
Other CRTC licence holder and exempted undertakings |
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| b) |
Daily newspaper |
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| c) |
Non-daily newspaper or other media publisher |
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| d) |
Production or distribution of programming material |
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| e) |
Lessor of property, plant or equipment of licensee |
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| f) |
Telecommunications company regulated under the Telecommunications Act |
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| g) |
Company owning securities in any of categories (a) to (f) |
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| 4.1 |
Describe the authorized service area noting the name of the principal community(ies): |
Distribution of services |
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| 4.2 |
Provide/confirm a website address where the distribution grid (i.e., the channel lineup) is listed, according to the licensed location. The distribution grid must contain the call sign and location or service name of each programming service, as well as the mode of distribution [basic (B) or discretionary (D)] and channel or frequency on which each signal is distributed (refer to Broadcasting Information Bulletin 2009-384). |
Promotion of disability-specific services and products
Websites
General call centres
Supporting document to be appended:
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| Appendix 4A |
Authorized service area (refer to Broadcasting Information Bulletin CRTC 2009-384) |
For radiocommunication distribution undertakings, a contour/service area map provided as part of the Industry Canada technical submission is to be provided electronically in one of the following formats:
A map provided in a GIS-compatible file format must be created using a map datum of NAD83. The Commission will only accept the following GIS-compatible file extensions:
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| Licensees are encouraged to post their service area maps or contour maps on their respective websites. |
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5. Employment equity |
| Information relating to employment equity is available
in Public Notices CRTC 1992-59 and 1997-34. |
| The Commission requires responses to questions regarding Employment Equity on behalf of the licensee as a whole, with reference to all of its employees in aggregate, that is, employees at all undertakings for which the licensee holds licences. |
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5.1 Is the licensee subject to the 1996 Employment Equity Act (applicable to federally-regulated employers with 100 or more employees)? Yes ( ) No ( ) If YES, do not complete the remainder of this section.
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| 5.2 Outline examples of any
measures (including hiring and training, apprenticeship programs,
work arrangements, etc.) that you have or will put in place for the designated groups (women, Aboriginal peoples, persons with disabilities and visible minorities). |
| Questions 5.3 to 5.5 - Applicable if between 25 and 99 employees only: |
| 5.3 How do you or will you communicate details of your employment equity policies to managers and staff? |
| 5.4 Have you assigned, or will you assign, a senior level person to be responsible for tracking progress and monitoring results? |
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Yes ( ) No ( ) |
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If YES, what authority does or will that person have to ensure goals are achieved? |
| 5.5
What financial resources do you have or will you put in place to promote employment equity in the workplace (for example, funds for daycare, access for
persons with disabilities, etc.)? |
Sections 30 to 34 of the Canadian Radio-television and Telecommunications Commission Rules of Practice and Procedure set out a process by which parties to Commission proceedings may file information on the record of a public proceeding in confidence.
A party filing information can “designate” it as confidential at the time it is filed with the Commission (section 31) if it falls into one of the following categories:
At the time that the party files the information it designates as confidential, it must provide an abridged version of the document along with an explanation of how the information falls into a category of information listed in section 31. The party must provide a detailed rationale to explain why the disclosure of the information is not in the public interest (section 32(1)).
The confidential version of the document must be filed separately and must be marked “CONFIDENTIAL” on each page. If the document is filed electronically, each file containing confidential information must include “CONFIDENTIAL” in the file name.
The abridged version of the document and the reasons for the designation of information as confidential will be placed on the public record of the proceeding.
Please consult the Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and the Procedures for filing confidential information and requesting its disclosure in Commission proceedings, Broadcasting and Telecom Information Bulletin CRTC 2010-961, 23 December 2010, for complete process for filing confidential information.
Are you requesting for some information to be designated as confidential?
Yes ( ) No ( )
If yes, you must provide a detailed rationale to explain why the disclosure of the information is not in the public interest :
Book of supporting documents
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APPENDIX NUMBER AND NAME |
APPENDED |
E-FILED |
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SECTION 1: GENERAL INFORMATION |
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1A |
Supplementary Brief | ||
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SECTION 2: OWNERSHIP |
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2A |
Amendments to constituting documents | ||
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SECTION 4: SERVICE INFORMATION |
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4A |
Map(s) - Authorized / Current service Area | ||
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***End of Document*** |