Administrative Proceedings (Various Requests - Excluding technical amendments) - Form 300

Sample form only: do not complete

This form is for reference purposes only. It is not to be completed in this format.

To complete this form online and submit it to the CRTC, log in to My CRTC Account via the Broadcasting Online Form and Cover Page.

General instructions

This application form is only to be used for applications that do not require a public process and that the Commission will deal with using the administrative approach. You may consult Broadcasting Information Bulletin CRTC 2010-960 for additional information. These applications do not fall under the Rules of Procedure with the exception of the confidentiality rules. The following applications may be subject to another process if they raise concerns.

Applicants who need further information relative to the CRTC processes can contact a Commission specialist at 1-866-781-1911.

Important notice: The Commission will return the application if it has not been duly completed. The onus will be on the applicant to submit a complete application that provides all of the relevant information, identifies all regulatory issues raised in the application and provides supporting documentation. All information with an * is required.

1. General information

*Please select the type of application you wish to submit:

  1. Application for the extension of a deadline for the implementation of an authority to provide a new service. ( )

  2. Application for the extension of a deadline for the filing of documentation or other information in response to a requirement made by the Commission in a decision. ( )

  3. Application for changes to the authorized areas of licensed broadcasting distribution undertakings. ( )

  4. Application by a licensee to revoke its licence. ( )

  5. Application to delete rebroadcasting transmitter(s). ( )
    Please specify the call sign of rebroadcasting transmitter(s) to be deleted: _____________________

  6. Application for amendments to conditions of licence to implement a regulatory policy of the Commission or to incorporate a standard condition.

    Note: Although this type of application may be processed through an administrative proceeding, the Commission requires that you complete form 301 entitled Amendment requests (excluding technical amendments) Part 1 Proceedings.

  7. Application for changes to the authorized contours of radio and television programming undertakings in cases where the revised contours do not enter a new market and the proposal will not result in a change of the operating class of a low-power station.

    Note: Although this type of application may be processed through an administrative process, the Commission requires that you complete form 303 entitled Application for a technical amendment to a broadcasting licence for an analog radio programming undertaking (including a new transmitter) and/or form 302 entitled Application for a technical amendment to a broadcasting licence for an analog or digital television programming undertaking (including rebroadcasting transmitters).

  8. Application for share transfer

    Note: Although this type of application may be processed though an administrative proceeding, the Commission requires that you complete form 139 entitled Application for authority to effect a change in ownership or control of a licensed broadcasting undertaking (Shares).

If your application does not fall within the above-mentioned categories, you are required to file your application using the appropriate amendment form:

( ) Part 1 Proceedings Amendment requests; or

( ) Application for a technical amendment to a broadcasting licence for an analog or digital television programming undertaking (including rebroadcasting transmitters); or

( ) Application for a technical amendment to a broadcasting licence for an analog radio programming undertaking (including a new transmitter)

1.1 Type of application

*Please select the appropriate type of form you are submitting

Radio ( )
Television ( )
Distribution ( )

Radio

Type of undertaking

AM ( )
FM ( )  Specialty FM Format ( )

Is this application to change or amend your format's condition of licence?

Yes ( )  No ( )

Other ( ) Please specify:

Sub-type of undertaking

Commercial ( )
Campus/Community ( )
Native ( )
Other ( ) Please specify:

Television

Type of undertaking

Conventional ( )
Pay ( )

Specialty

Category A ( ) Category B ( ) Category C ( ) Analog ( ) Category 1 ( ) Category 2 ( )

Pay-Per-View ( )

Video-On-Demand ( )

Satellite-to-cable ( )

Other ( ) Please specify:

Distribution

Terrestrial:

Cable ( ) IPTV ( )

Radiocommunication (off-air):

RDU ( )

SRDU ( )

Satellite

DTH ( )

Other ( ) Please specify:

If you are a distribution undertaking:

  1. Are you applying for a change to the authorized service area?

Yes ( ) No ( )

If yes, you must provide a revised map which clearly reflects which portion is currently authorized and which portion is proposed in the extension as Appendix A.

You must file a service area map that reflects the boundaries of the service area in one of the following formats:

A map provided in a standard image or PDF file format must be in a scale that readily permits precise identification of the boundaries of the service area and depicts the location in relation to its surrounding areas. This map must provide a level of detail comparable to that contained in the paper map previously required by the Commission (1:50,000 NTS topographical map).

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:

  1. Confirm that all priority programming services will be offered in the proposed service area as stated in the Broadcasting Distribution Regulations.

1.2 Identification of applicant

*Corporation ( ) Other ( ) Please specify: _____

*Name of legal entity who is authorized by the Commission to operate this undertaking:

*Call sign or name of service:

*Address:

*City / Town:

*Province/Territory:

*Postal code:

*Telephone:

 Facsimile:

Contact person representing the applicant (if there is no designated representative under question 1.3)

*Name:

*Title:

*Email:

*Telephone:

1.3 Designated representative

I, _________________________, the applicant, hereby designate _____________________ as my designated representative 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:

At:

Example: city, province
Signature (not required when submitting electronically):

Address of agent:

Title:

Telephone:

Facsimile:

E-mail:

1.4 Declaration of the applicant or its designated representative

I, *___________________________________ solemnly declare that:

  1. I am the designated representative of the applicant named in this application and as such have knowledge of all matters declared therein.
  2. 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.
  3. 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.
  4. I have examined the provisions of the Broadcasting Act, the broadcasting regulations and policies relevant to this application.

And I have signed
*Signature (not required when submitting electronically):
*Date:

Witnessed by
*Signature (not required when submitting electronically):
*Name:
*Date:
*At: Example: city, province

2. Application

The Commission will return the application if it has not been duly completed. The onus will be on the applicant to submit a complete application that provides all of the relevant information, identifies all regulatory issues raised in the application and provides supporting documentation.

*Submit a website address or e-mail address where an electronic copy of the application may be requested:

Website:

Example: www.mycompany.com

E-mail:

Example: no-reply@no-reply.com

2.1 Description of application

  1. *Are you requesting that your licence be revoked?
    Yes ( ) No ( )
    If yes, you must answer question b)
    If no, proceed to question f)

  2. Do you believe you are eligible for an exemption order?
    Yes ( ) No ( )
    If yes, you must answer question c) and d)
    If no, proceed to question f)

  3. Please specify the exemption order that applies to your service.

  4. Certain exemption orders require that you file specific information with the Commission when requesting a revocation or when ready to commence operations

    Please indicate whether such information is required as per the exemption order you have identified:
    Yes ( ) No ( )
    If yes, you must answer question e)
    If no, proceed to section 3

  5. Please provide the information required in the exemption order:

  6. Please provide a description of your application.

  7. Provide the rationale for the proposed amendment(s) including a clear and concise statement of the relevant facts as well as the grounds of the application.

  8. Provide the nature of the decision sought:

  9. Provide the CRTC decision number of the decision that:

    1. Imposed the deadline for which you are asking an extension; or
    2. Most recently approved the authorized area of a BDU; or
    3. Most recently renewed the licence of the station/service (or issued the licence if in the first term)

3. Request for documents to be designated as confidential

Sections 30 to 34 of the Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 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:

  1. Information that is a trade secret;
  2. Financial, commercial, scientific or technical information that is confidential and that is treated consistently in a confidential manner by the person who submitted it; or
  3. Information the disclosure of which could reasonably be expected
    1. To result in material financial loss or gain to any person;
    2. To prejudice the competitive position of any person; or
    3. To affect contractual or other negotiations of any person.

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 Procedures for filing confidential information and requesting its disclosure in Commission proceedings, Broadcasting and Telecom Information Bulletin CRTC 2010-961 for complete process for filing confidential information.

*3.1 Are you requesting for some information to be designated as confidential?

Yes ( ) No ( )

If yes:

  1. Provide a detailed rationale to explain why the disclosure of the information is not in the public interest:

You may submit any additional documents as part of your application after selecting the "Submit" option below.

4. Documents to be appended to the application and naming convention of electronic documents

Documents should be submitted in an accessible format (Broadcasting and Telecom Information Bulletin CRTC 2015-242)

The following documents should be submitted as separate electronic documents using the naming convention specified below. The document number (Doc#) indicates the ascending order in which the documents should appear on the public file.

The document name should not exceed 150 characters or include any special characters (%, $, &, /, (), #, etc).

The document should not be submitted in .xhtml format.

Table 1 - Naming convention for the electronic documents
Document Electronic file name Appended Confidential
Appendix A Doc1 - Service area map    
Additional documents Doc# - "Specify name of document"    
Each confidential document NOT WEB - Doc# - CONFDOC - "brief description of the document"    
Abridged version of each confidential document Doc# - ABRIDGED VERSION - "same description of document for which confidentiality is requested"    

CRTC 300 (2015-06-11) – Administrative Proceedings

***End of Document***

Date modified: