The completed SF-424 actually will be the first three pages of your application.
☛ PTFP strongly recommends that you use the on-line fillable version of the SF-424, which
you will find at www.ntia.doc.gov/ptfp/application/appform.htm. It has the instructions,
some items are pre-filled, and selection boxes help you complete others. If you enter all
equipment you are requesting with the costs, the online system will automatically calculate
totals and put the dollar amounts in the correct places in the forms.
☛ You may want to print out these instructions to use as a checklist as you go.
____ 1. Type of Submission: Check “Application.”
____ 2. Type of Application: Check “New” if you are preparing the first submission of this project in this grant
cycle. Check “Revision” if PTFP has requested changes in your application.
____ 3. Date Received: Leave blank for PTFP use.
____ 4. Applicant Identifier: Complete the box if your organization has assigned a number or
other identifier to the project.
____ 5a. Federal Entity Identifier: Leave blank for PTFP use.
____ 5b. Federal Award Identifier: Leave blank for PTFP use.
____ 6. Date Received by State: Use if your state participates in the Single Point of Contact
process (see No. 19, below).
____ 7. State Application Identifier: Insert number assigned under the Single Point of Contact
process if applicable.
____ 8. Applicant Information:
a. Legal Name: Enter the legal name of the organization responsible for any award.
b. Enter Employer’s Identification Number (EIN) assigned by the Internal Revenue
Service. (It will be redacted prior to any disclosure to the public.)
c. Enter the DUNS number assigned to your organization by Dun and Bradstreet, Inc.
You may obtain a DUNS number at no cost by calling the toll-free DUNS request
telephone, 1-866-705-5711, or via the Internet at fedgov.dnb.com/webform. A
DUNS number is required on all applications.
d. Address: Please enter a street address because a P.O. Box number cannot be used
for over-night delivery, which PTFP uses to send out grant awards and other
e. Organizational Unit: If your organization uses Department and/or Division
designations, enter them as appropriate.
f. Name and contact information of person to be contacted on matters involving
this application: Enter name, title, telephone number, fax number and e-mail
address of the person PTFP should contact on all non-engineering matters related to
this application and who will be responsible for your project if it is funded.
____ 9. Type of Applicant: In the first space, enter the letter from the list below that best
describes the applicant organization. If you wish, you may further describe your
organization by entering an additional letter in each of the other spaces.
A. State Government
N. Nonprofit without 501(C)(3) IRS status
B. County Government
O. Private Institution of Higher Education
C. City or Township Government
D. Special District Government
Q. For-Profit Organization (other than Small Business)
F. U.S. Territory or Possession
R. Small Business
G. Independent School District
S. Hispanic-Serving Institution
H. Public/State controlled Institution of Higher Education
T. Historically Black Colleges and Universities (HBCUs)
I. Indian/Native American Tribal Government (Federally recognized)
U. Tribally Controlled Colleges and Universities (TCCUs)
J. Indian/Native American Tribal Government (other than Federally recognized)
V. Alaska Native and Native Hawaiian Serving Institutions
K. Indian/Native American Tribally Designated Organization
W. Non-domestic (non-US) Entity
L. Public/Indian Housing Authority
X. Other (specify)
M. Nonprofit with 501(C)(3) IRS status
____ 10. Name of Federal Agency: Enter “NTIA”.
____ 11. Catalog of Federal Domestic Assistance Number: Enter “11.550”. Under CFDA
title, enter “PTFP”.
____ 12. Funding Opportunity Number/Title: Enter “Public Telecommunications Facilities
____ 13. Competition Identification Number/Title: Leave blank.
____ 14. Areas Affected by Project (Cities, Counties, States, etc.): List the largest political
units affected by the project.
____ 15. Descriptive Title of Applicant’s Project: Enter “Construction Project” . (PTFP uses
the term “construction” to mean the purchase of telecommunications equipment for a
telecommunications project) or “Planning Project,” as appropriate.
____ 16. Congressional Districts of:
____ a. Applicant. Enter the number of the Congressional District that includes the
applicant’s headquarters; this can be only one number.
____ b. Program/Project. Enter the numbers of all Congressional Districts in all
states that would be reached by the proposed project. If a state has only one
Congressional District, enter “1”.
____ 17. Proposed Project and End Dates: For the start date, enter “10/01/11”. For the end
date, use six-month increments to estimate the completion date of your project (e.g.,
9/30/12, 3/31/13, or 9/30/13).
____ 18. Estimated Funding ($): Boxes “a,” “b,” and “g” summarize your request for funding
from Standard Form 424A, the Budget Form, which is discussed below.
____ Box “a,” Federal. PTFP (Federal) share. For construction project applications,
box “a”cannot exceed 75% of the total in box “g” (not even by 1¢).
____ Box “b,” Applicant. Applicant’s share
This item is automatically completed for applicants requesting a Construction grant and using PTFP’s online fillable form:
1. First, complete the PTFP-2 Form
2. Second, enter all equipment costs using the Equipment Tab
3.Third, click on the Budget tab and enter the Federal amount on Line B1.
PLANNING APPLICANTS: Review the planning guidance, below, regarding the Standard Form 424A, the Budget Form.
Note: Leave boxes “c,” “d,” “e,” and “f” blank.
____ Box “g,” total may include only eligible costs.
____ 19. Is Application Subject to Review by State Executive Order 12372 Process?
____ If your state participates in the State Single Point of Contact (SPOC) review process under Executive Order 12372,
check box “a” and enter the date you send a copy of the application to the state
office. (A list of SPOC offices is available through the Office of Management and Budget home page at http://www.whitehouse.gov/ombgrants_spoc.)
____ If your state does not participate, check “b” or “c” as appropriate.
____ 20. Is the Applicant Delinquent on Any Federal Debt? (If “Yes”, provide
explanation.) This question applies to the entire applicant organization, not to the
authorized representative or to an individual department. Categories of debt include,
but are not limited to, delinquent audit related debts, loans, and Federal taxes. Check
the appropriate box. Attach an explanation if required.
____ 21. The authorized representative of your organization must be able to check the “I
Authorized Representative: Fill in the boxes as indicated. The application must be
signed by an authorized representative of the applicant organization. A copy of its
governing body’s authorization for the individual to sign this application must be on
file in the applicant’s office and available for inspection.
PTFP REQUIRES ORIGINAL SIGNATURES ON ALL APPLICATIONS,
preferably in a color ink other than black.
Standard Form 424A — Budget Information — Non-Construction Programs
This form is required from all applicants. It is discussed after the PTFP-2.
Standard Form 424B — Assurances — Non-Construction Programs
This form is required from all applicants. It is discussed below
in the section on Exhibits.
Project Information Form
The completed PTFP-2 will be page 2 of your application.
☛ As with the SF-424, PTFP recommends that you use the on-line fillable version of the PTFP-2 Form, which is at www.ntia.doc.gov/ptfp/application/appform.htm. Follow these instructions: to complete the PTFP-2 Form.
____ 22. Applicant Name. Enter legal name from page 1, item 5, SF-424.
____ 23. Reactivation. If this is a reactivation of an application deferred from last year’s PTFP
grant cycle; enter “Y” in item 23a and last year’s application number in 23b.
(Note: The PTFP Final Rules permit only two reactivations of a deferred application, for
a total of three years consideration; see §2301.9.
____ 24. Enter the call letters and frequency (or channel number, as appropriate) of the public
radio or television station that is the subject of this application. Use the main station
call letters if the application is for a translator or multiple facilities. If the facility has no
call letters, please enter “N/A.” The call letters will be included in all correspondence
regarding the application.
____ 25. Prior PTFP grants. If the applicant has received a prior PTFP grant, check “Yes” and
enter a recent grant number for identification. If not, check “No”.
____ 26. Enter letters to classify the project. Enter “C” (Construction) or “P” (Planning); “R” (Radio), “T” (Television), or “RT” (Radio/Television), as appropriate; and “B” (Broadcast), “N” (Nonbroadcast) or “BN” (Broadcast/Nonbroadcast), as appropriate.
Applications may combine elements of radio and television but rarely combine broadcast and nonbroadcast.
____ 27. Priority/Category. Enter the Priority or Category listed in §2301.4 of the PTFP Rules
or the Federal Funding Opportunity Notice under which you request the application be
Note that PTFP reserves the right to change the priority/category during its review of the
____ 28. For New Broadcast stations, repeaters and translator applications. Number of people served by the project. Please explain and document the following
in Exhibit D:
FIRST signal: Enter the number of people who currently receive no public radio or TV
signal from any station and who will receive their first public radio or TV signal as a
result of this project.
ADDED signal: Enter the number of people who will receive their second (or third,
etc.) public radio or TV signal as a result of this project.
____ 29. Engineering contact information. Enter the information for the person PTFP should
contact on engineering matters related to this application.
____ 30. Summary of Application. State the objective of your application in one brief sentence;
e.g., “Anytown University seeks funding assistance to replace the transmitter, antenna,
and transmission line of public radio station WANY.”
☛ Supporting arguments and justifications for your project go in the Narrative and
Exhibits, not here.
____ 31. FCC Authorizations. If a new FCC authorization is required to complete your project,
provide the following information for each approval required:
____ FCC Community of license.
____ Channel # (e.g., “89.9” for FM, “9” for TV, etc.)
____ FCC File number (e.g. “BPED040898AB”).
____ Common name used when referencing the transmission site in other parts of the
application (e.g., “Northwest National Forest”, “Old McDonald Farm”, “Central
____ Indicate by placing a “Y” or “N” in the appropriate space whether your
organization owns or leases the transmission site. If site rights are pending,
place a “P” in the appropriate space.
____ 32. Other Sources of Funding. Indicate whether funding to support this project has been or will be sought from any other Federal program or the Corporation for Public Broadcasting (CPB).
Please note that PTFP will not accept applications that contain equipment for which funds have or will be requested from CPB or another Federally funded program. Acceptable support could include funding to support programing or staff needed to operate the equipment as well as funding for other equipment integral for the operation of the PTFP requested equipment.
____ Please provide information about funding from other Federal programs or CPB
in the program narrative.
____ 33. CPB Qualification. Check “Y” or “N” to indicate whether your organization currently
receives, or anticipates receiving, financial assistance from the Corporation for Public
Please note: In order to receive a PTFP grant, your organization does NOT have to
receive financial assistance from CPB.
____ 34. Similar Public Telecommunications Facilities within Project Service Area. List all
acceptable signals of other public telecommunications facilities of the same type as the
subject of this application.
(You are not required to provide exact contours of other stations, only to list those
stations that can be viewed or heard within the service area of the proposed project.)
____ TV If this application is for a television project, list all public TV stations
providing a Grade B signal within the project’s service area.
____ Radio If this application is for a radio project, list all other public radio stations
that provide a 1 mv/m signal within the project’s service area.
____ 35. Station Operations. Indicate the number of full-time paid employees, part-time paid
employees, and volunteers currently on the staff of the organizational unit for which the
project is intended.
____ Show also the total hours worked by an average staff member in each category in
an average week. Then show comparable numbers projected for when the new
facilities are in operation.
____ Indicate the current operating budget, if any, and projected budget for the first
year of operation following construction of the proposed facilities.
Application for Federal Assistance
Standard Form 424A
Budget Information — Non-Construction Programs
The first page of the 424A will be page 3 of your completed application. It is
the standard budget form now used by all Federal grant programs.
● Budget Information Instructions for PTFP Construction Applications
☛ If you use the on-line fillable version of the Application Form, the system automatically fills out the SF-424A for Construction Applicants.
○ Submit only page 1 of the SF-424A. Complete only Section B, columns 1 and 5 under item
6, “Object Class Categories.”
○ Put the total for all equipment, including contractor installation costs, in columns 1 and 5 on
line 6d, Equipment. This amount should equal the total of all PTFP-4 (equipment list) pages
○ Place all other eligible costs in columns 1 and 5 on line 6h, Other.
○ Attach a page to the SF 424A detailing the other eligible costs, and that provides sufficient
explanation in order to establish the need for the funds, the basis for figures used and how
they were calculated, per the following example:
Conduct site evaluations,
perform engineering studies,
meet with station Board and
prepare FCC applications
$100 per hour
○ Show totals in columns 1 and 5 on line 6k, totals.
● Budget Information Instructions for PTFP Planning Applications
○ The SF424A Budget Form for Planning Applications in NOT automated. A web version can be found here. Complete the Form as follows:
____ Submit only page 1 of the SF-424A. Complete only Section B, columns 1 and 5 under item
6, “Object Class Categories.”
____ Complete Lines 6a-6k, as appropriate for your project.
All costs included in the proposed project should be broken down into the categories listed.
Enter the totals for each category in columns 1 and 5 on the appropriate line on the form.
Attach a Budget Detail and Budget Narrative to the SF-424A.
◦ 6a Personnel. List each employee, full-time equivalency, and payment.
◦ 6b Fringe Benefits. List fringe benefits and method of calculating benefits.
◦ 6c Travel. Break down travel into local and overnight, with projected areas of travel
◦ 6d Equipment. Equipment may include office equipment to support the planning
function, but cannot include equipment to establish a telecommunications facility.
◦ 6e Supplies. List supplies projected to support the planning activity.
◦ 6f Contractual. List contractors, such as consultants, amount to be paid, and basis for
◦ 6g Construction. Leave blank; construction costs are not funded.
◦ 6h Other. List any additional eligible expenses required to support the planning
◦ 6i Subtotal of columns 1 and 5.
◦ 6j Indirect Costs. Enter Indirect Costs charged to the project. Document the indirect
rate in the Budget Narrative.
◦ 6k Total of columns 1 and 5, including indirect charges requested. Whole dollars only.
○ Print the SF424A Form and insert it as Page 3 your application.
○ Transfer the Total (line 6K) to line 18(g) of the SF424 Form. Place your request (Federal Share) in line 18(a) and your local matching share (Applicant Share) in line 18(b).
○ Budget Detail. You must also attach a budget detail that provides a line item breakdown of
project costs within each budget category. See the following example, where each category
is detailed by “Line Item”, “Federal Support,” “Matching Support,” and “Total.”
Engineer to prepare FCC
Attorney to prepare FCC
○ Budget Narrative. You must attach a budget narrative that provides sufficient explanation
of each budget category in order to establish the need for the funds in each category, and the
basis for figures used and how they were calculated, per the following example:
meet with station Board
and prepare FCC
☛ Start date to obligate Federal funds. No funds from the Federal share of the total project cost may be obligated until the Grant Award Period start date. PTFP Award Periods usually begin October 1. PTFP considers money to be obligated when the Applicant enters into any
sort of binding commitment to spend the money. This means the formal acceptance of a bid
offering or the issuance of a purchase order.
After the Closing Date, the applicant may, at its own risk, obligate non-Federal matching funds for the acquisition of proposed equipment. If you obligate the local match before a grant is formally awarded, you face two primary risks:
1. You may not be offered a grant award, or
2. Negotiations may reduce the amount of the total project cost, and if you have obligated
funds in excess of the negotiated local match, the Federal share will be correspondingly
reduced, or an eventual award may be reduced or terminated.
Eligible Equipment Form
The PTFP-4 form will be page 4 of your completed Construction Project application.
☛ Planning Applications do not include the Equipment Form.
☛ Complete the left side of this Form. When you use the on-line fillable version of the
Application Form, the system transfers the total to the SF-424A (Budget Information).
● Make photocopies of the form and use as many pages as necessary to list all of the equipment
categories requested. Retain a blank original in case PTFP requests revisions.
● Please number multiple pages PTFP-4-1, PTFP-4-2, PTFP-4-3, etc.
● Before you complete the Equipment Request portion (left side) of this form, you should review
PTFP’s list of eligible and ineligible equipment and project costs here.
● Multiple sites. If the requested equipment will be placed at several sites, enter the equipment
for each location on a separate page. Identify the location for each page on the top line.
● Enter only one equipment category on a page. Arrange the equipment requested into the
categories described below.
● Check one of the four boxes in the top block to indicate the category of equipment requested on
A. Dissemination Equipment. Includes antennas, towers, transmitters, STLs, translators,
cable/ITFS distribution systems, and equipment required for transmission of a broadcast
signal or delivery of non-broadcast programing to the audience.
B. Origination Equipment. Includes master control equipment for production of television or radio
programs, including such items as cameras, microphones, turntables, recorders, switching
equipment, consoles, mixers, editing systems, signal processors, production lighting
equipment, and other items necessary for production of broadcast-quality programing.
C. Interconnection Equipment. Includes microwave, fiber, and satellite equipment.
D. Test Equipment Includes test items necessary for good engineering practice or
Other eligible equipment. Specify any other eligible equipment not included under the
other categories, such as specialized receivers used by handicapped groups (i.e., sub-carrier
[SCA] receivers, caption decoders, and similar equipment).
● Identify all major items required for the project. Proposed acquisition of multiple items
grouped together for one price must be categorized sufficiently to provide assurance that no
ineligible items are included.
● In the column headed Item, place a general description of the equipment item in question;
examples would be “studio cameras”, “video production switcher”, or “audio console”.
● In the column headed Description, place the manufacturer and model number of the item.
(This information indicates only the level of quality of the item. After competitive bidding,
different manufacturers and models are commonly purchased.)
● The column headed Cost should include the total cost for that item..
☛ Do not enter eligible Non-equipment Costs on this page. They should be included on the
Budget Form, SF-424A, line 6h Other with an attached explanation.
● Ownership of equipment.
Generally, equipment listed as part of the proposed project cannot be owned by the applicant,
nor can any funds be obligated towards its purchase, before the PTFP closing date for the year
the application is (or was) first submitted to PTFP. Inclusion of equipment purchased prior to
the closing date will be considered on a case-by-case basis only when clear and compelling
justification is provided to NTIA. Obligating funds — either in whole or in part — for equipment before the Closing Date is considered ownership or acquisition of equipment. In like manner, accepting title to donated equipment prior to the Closing Date is considered ownership or acquisition of equipment.
● Installation Costs.
NTIA support for installation costs depends on what is to be installed and by whom:
○ Transmission Equipment. NTIA strongly favors the use of either manufacturer or
professional contractor personnel for the installation of transmission equipment and
commonly funds these costs.
○ Master Control, On-Air and Production Control, and Production Equipment. NTIA will
support appropriate costs if you use an integrator to design and install your system and to be
responsible for documentation and proper communication between items of equipment, such
as servers, routing switchers, automation, and audio and/or video storage devices. NTIA
will also support appropriate costs if professional contractors to supplement staff installers
are used for the installation of such equipment.
○ Staff installation. NTIA will rarely support staff installation costs. NTIA will take into
account a demonstration of exceptional need for support of such installation, in which case
cost estimates should be based on existing wage scales.
○ List installation costs separately on the lines “Contractor installation” and “Staff
○ Include installation costs on the PTFP-4 form and in line 6d of the SF-424A form.
● Donated Equipment.
Items of donated equipment that are part of the proposed project should be listed within the
proper categories along with items to be acquired with grant funds. Place the fair market value
of donated items in the “request” section. As noted above, you may take title to donated
equipment prior to the closing date only upon presentation and acceptance by NTIA of clear and
If donated equipment is to be used for the local match, your application should include a
certified appraisal from a qualified, independent engineer as to the age, fair market value, and
remaining useful life of the donated items. In addition, you must include a letter from the donor
confirming the donation. Attach the appraisal document and the donation letter to Exhibit B.