NBA TV

Authorization and Zipcode/Service Area Form

MSO/Owner:

Headend Name:

SID #:

-

Headend Address:

City:

State:

Zipcode:

Designated Market Area (DMA):

System Engineer:

Engineer Phone:

Engineer email:

Motorola Digicipher Receiver:

Headend fed iND programming from:

N/A

Name & Location:

Form completed by:

Phone

Date:

Please complete and email this form along with an Authorization Form to your Affiliate Representative

SATELLITE - AMC-1, TRANSPONDER 8 (V) C Band
VCT - 00167 -- L BAND FREQUENCY - 1290
Channel	MPEG#	TSODA / ACP	Decrypt Address
Anchor
Placeholder		1A / 1(0)
Placeholder		1B / 1(1)
Placeholder		2A / 2(0)
Placeholder		2B / 2(1)
Placeholder		3A / 3(0)
Placeholder		3B / 3(1)
NBA TV	7	4A / 4(0)

Please check one of the boxes below

Please use current Zipcode Service Area and Hub Site List already on file for NBA LEAGUE PASS

Please use the below list of Zipcodes and Hub Sites (complete both sections below)

ZIPCODES SERVED

(attach additional sheet if necessary)

Identify all zipcodes and Cities serviced by the headend indicated at the top of this form.

DO NOT include zipcodes from hubs fed from this location – each hub must submit zipcodes independently.

Zipcode

City/Town

Zipcode

City/Town

Zipcode

City/Town

Zipcode

City/Town

HUB SITES

(attach additional sheet if necessary)

Please identify “Hub Sites” fed by the headend indicated at the top of this form. If “none” please indicate so.

Each hub site’s zipcode/service area must be submitted on it’s own “INHD Zipcode/Service Area” form

Headend Name

Headend Name