Notification for Spectrum Manager Lease Sample Clauses

Notification for Spectrum Manager Lease. In order for Sensus to apply to the FCC on the Customer’s behalf for a spectrum manager lease, Customer must complete the information below in boxes one (1) through ten (10) and certify via authorized signature. Customer’s signature will indicate that Customer authorizes Sensus to file the spectrum manager lease notification on FCC Form 608 with the Customer as spectrum Lessee, and if Customer does not already have one, ownership disclosure information on FCC Form 602. 1 Customer/Lessee Name: City of Santa Xxxx Attention To: Xxxxx Xxxxx, Director of Santa Xxxx Water Name of Real Party in Interest: Street Address: 00 Xxxxx Xxxx Xxxxxx City: Santa Xxxx State: CA Zip: 95404 Phone: 000-000-0000 Fax: 000-000-0000 Email: XXxxxx@xxxxxx.xxx Is Customer contact information same as above? Yes Additional Customer/Lessee Contact Information No (If No, complete box 2 below) 2 Company Name: Attention To: Street Address: City: State: Zip: Phone: Fax: Email: Customer/Lessee is a(n) (Select one): Individual ǀ Unincorporated Association ǀ Trust Government Entity ǀ Corporation ǀ Limited Liability Company ǀ General Partnership Limited Partnership ǀ Limited Liability Partnership ǀ Consortium ǀ Other FCC Form 602: FCC File Number of Customer’s Form 602 Ownership Information: . If Customer has not filed a Form 602, Sensus will file one for Customer. Please complete questions 5, 6, and 7 below if Customer does not have a Form 602 on file. Customer must complete items 8, 9 and 10 irrespective of whether Customer has an ownership report on file. Customer Tax ID: 00-0000000 Individual Contact For FCC Matters Please designate one individual (the Director of Public Works or similar person) who is responsible to the FCC for the operation of the FlexNet radio system. Name Xxxxx Xxxxx Title: Director of Santa Xxxx Water Email: XXxxxx@xxxxxx.xxx Phone: 000-000-0000 Ownership Disclosure Information 7 If Customer/Lessee is a government entity, list the names of the Mayor and all Council Members below, as well as verify citizenship and ownership interests in any entity regulated by the FCC. Such ownership must be disclosed where a mayor/council member owns 10% or more, directly or indirectly, or has operating control of any entity subject to FCC regulation. If any answer to Ownership question is Yes, or any answer to Citizenship question is No, provide an attachment with further explanation. US Citizen? Ownership Disclosure? Mayor: Xxxx Xxxxxx Yes No Yes No Council Member: Xxx Xxxxxxxxxx Yes...
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