Federal Communications Commission
Study Area Boundary Recertification
OMB Control Number: 3060-1181
I hereby certify that the study area boundary data last submitted to the Federal Communications 
Commission is accurate and correct to the best of my knowledge, information, and belief.
A list of Study Area Codes for recertified boundaries must be attached to this Notification.  
State Entity: ____________________________________________________
First Name: ________________________
Last Name: ________________________
Street Address: _______________________________________________________
_______________________________________________________
City: _______________________________
State: ______________________________
Zip Code: ___________________________
Phone Number: ______________________
E-mail: _____________________________________________________________
_____________________________________ _______________________
Signature Date