Signed Form 312

0263-EX-ST-2005 Text Documents

Globecomm Systems, Inc.

2005-05-17ELS_70835

Approved by OMB 3060.0678 FCC Use Only Ext, Avg. Burden Hours File Number: Eggri 12 FEDERAL COMMUNICATIONS COMMISSION Per Responae: 11 Hin. APPLICATION FOR SATELLITE SPACE AND EARTH STATION AUTHORIZATIONS Call Sign: Fee Number: APPLICANT INFORMATION 1. Legal Name of Applicant 2. Voice Telephone Number Globecomm Systems, Inc. (631) 231 — 9800 3. Other Name Used for Doing Business (if any) 4. Fax Telephone Number (631) 231 — 1557 5. Mailing Street Address or P.O. Box 6. City 45 Oser Avenue Hauppauge 7. State/Country (if not U.S.A.) 8. Zip Code ATTENTION: GERRY JOHNSTON SR. New York 11788 — 3816 9. Name of Contact Representative (If other than applicant) 10. Voice Telephone Number Michelle McClure (202) 728 — 0400 11. Firm or Company Name 12. Fax Telephone Number Irwin, Campbell, and Tannenwald, P.C. (202) 728 — 0354 13. Mailing Street Address or P.O. Box 14. City 1730 Rhode Island Avenue, NW., Suite 200 Washington 15. State/Country (if not U.S.A.) 16. Zip Code ATTENTION: District of Columbia 20036 — 3101 CLASSIFICATION OF FILING 17. Place an "X" in the box next to the classification that applied to this filing for both questions a. and b. Mark only one box for 17a and only one box for 17b. & al. Earth Station D b1. Application for License of New Station D b6. Transfer of Control of License or Registration D b2. Application for Registration of New l___l b7. Notification of Minor Modification EI a2. Space Station Domestic Receive—Only Station I:] b3. Amendment to a Pending Application D b8. Application for License of New Receive—Only Station Using Non—U.S. Licensed Satellite D b4. Modification of License or Registration D b9. Letter of Intent to Use Non—U.S. Licensed Satellite to provide Service in the United States D b5. Assignment of License or Registration IZ b10. Other (Please Specify): Special Temporary Authority FCC 312, Main Form—Page 1 February, 1998

18. If this filing is in reference to an existing station, enter: 19. If this filing is an amendment to a pending application enter Call sign of station: (a) Date pending application was filed: (b) File number of pending application: TYPE OF SERVICE 20. NATURE OF SERVICE: This filing is for an authorization to provide or use the following type(s) of service(s): Place an "X" in the box(es) next to all that apply. & a. Fixed Satellite D c. Radiodetermination Satellite D e. Direct to Home Fixed Satellite [_] b. Mobile Satellite [_] q. Earth Exploration Satellite [_] £. Digital Audio Radio Service [_] g. Other (Please Specify) 21. STATUS: 22. If earth station applicant, place an "X" in the box(es) next to all that apply. D a. Common Carrier & b. Non—Common Carrier & a. Using U.S. licensed satellites & b. Using Non—U.S. licensed satellites 23. If applicant is providing INTERNATIONAL COMMON CARRIER service, see instructions regarding Sec. 214 filings. Mark only one box. Are these facilities: I:] a. Connected to the Public Switched Network & b. Not connected the Public Switched Network 24. FREQUENCY BAND(S): Place and "X" in the box(es) next to all applicable frequency band(s). [_] a. C—Band (4/6 GHz) [X b. Ku—Band (12/14 GHz) [_] c. Other (please specify) TYPE OF STATION 25. CLASS OF STATION: Place an "X" in the box next to the class of station that applies. Mark only one box. [_] a. Fixed Earth Station [X] b. Temporary—Fixed Earth Station [_] c. 12/14 GHz VSAT Network [_] d. Mobile Earth Station [_] e. Space Station [_] £ Other (Specify) If _space station applicant, go to Question 27. 26. TYPE OF EARTH STATION FACILITY Mark only one box. & a. Transmit/Receive D b. Transmit—Only D c. Receive—Only PURPOSE OF MODIFICATION OR AMENDMENT 27. The purpose of this proposed modification or amendmentis to: Place and "X" in the box(es) next to all that apply. [:] a— authorization to add new emission designator and related service D b — authorization to change emission designator and related service D c — authorization to increase EIRP and EIRP density D d — authorization to replace antenna D e — authorization to add antenna D f— authorization to relocate fixed station l__—l g — authorization to change assigned frequency(ies) [:I h — authorization to add Points of Communication (satellites & countries) [:l i — authorization to change Points of Communication (satellites & countries) D j — authorization for facilities for which environmental assessment and radiation hazard reporting is required FCC 312, Main Form—Page 2 February, 1998

_ [_] k — Other (Please Specify) ENVIRONMENTAL POLICY 28. Would a Commission grant of any proposal in this application or amendment have a significant environmental impact as defined by 47 CFR 1.1307? If YES, submit the statement as required by Sections 1.1308 and 1.1311 of the Commission‘s rules, 47 C.F.R. §§ 1.1308 and 1.1311, as an exhibit to this application. [] vEs B no ALIEN QOWNERSHIP 29. Is the applicant a foreign government or the representative of any foreign government? [_] YES [X No 30. Is the applicant an alien or the representative of an alien? [:| YES [ no 31. Is the applicant a corporation organized under the laws of any foreign government? | [] yEs EJ no 32. Is the applicant a corporation of which more than one—fifth of the capital stock is owned of record or voted by aliens or their representatives or by a foreign government or representative there of or by any corporation organized under the laws of a foreign D YES NO country? 33. Is the applicant a corporation directly or indirectly controlled by any other corporation of which more than one—fourth of the capital stock is owned of record or voted by aliens, their representatives, or by a foreign government or representative thereof or by any D YES g NO corporation organized under the laws of a foreign country? 34. If any answer to questions 29, 30, 31, 32 and/or 33 is Yes, attach as an exhibit, the identification of the aliens or foreign entities, their nationality, their relationship to the applicant, and the percentage of stock they own or vote. BASIC QUALIFICATIONS 35. Does the applicant request any waivers or exemptions from any of the Commission‘s Rules? If Yes, attach as an exhibit, copies of the requests for waivers or exception with supporting documents. D YES Iz NO 36. Has the applicant or any party to this application had any FCC station authorization or license revoked or had any application for an initial, modification or renewal of FCC station authorization, license, or construction permit denied by the Commission? If Yes, D YES NO attach as an exhibit, an explanation of the circumstances. 37. Has the applicant, or any party to this application, or any party directly or indirectly controlling the applicant ever been convicted of a felony by any state or federal Court? If Yes, attach as an exhibit, an explanation of the circumstances D YES NO 38. Has any court finally adjudged the applicant, or any person directly or indirectly controlling the applicant, guilty of unlawfully monopolizing or attempting unlawfully to monopolize radio communication, directly or indirectly, through control of manufacture D YES !Z NO or sale of radios apparatus, exclusive traffic arrangement or any other mean or unfair method of competition? If Yes, attach as an exhibit, an explanation of the circumstances. 39. Is the applicant, or any person directly or indirectly controlling the applicant, currently a party in any pending matter referred to in the preceeding two items? If Yes, attach as an exhibit, an explanation of the circumstances. D YES [z NO 40. If the applicant is a corporation and is applying for a space station license, attach as an exhibit the names, addresses, and citizenship of those stockholders owing of record and/ or voting 10 percent or more of the Filer‘s voting stock and the percentages so help. In the case of fiduciary control, indicate the beneficiary(ies) or class of beneficiaries. Also list the names and addresses of the officers and directions of the Filer. FCC 312, Main Form—Page 3 February, 1998

41. By checking Yes, the undersigned certifies, that neither the applicant nor any other party to the application is subject to a denial of Federal benefits that includes FCC benefits pursuant to Section 5301 or the Anti—Drug Act of 1988, 21 U.S.C. Section 862, because & vFES & No of a conviction for possession or distribution of a controlled substance. See 47 CFR 1.2002(b) for the meaning of "party to the application" for these purposes. 42a. Does the applicant intend to use a non—U.S. Licensed satellite to provide service in the United States? If yes, answer 42b and attach an exhibit providing the information specified in 47 C.F.R § 25.137, as appropriate. I:I YES & NO If no, proceed to question 43. 42b. What administration has licensed or is in the process of licensing the space station? If no license will be issued, what administration has coordinated or is in the process of coordinating the space station? 43. Description. (Summarize the nature of the application and the services to be provided). Globecomm Systems, Inc., seeks a Special Temporary Authority (STA) for 90 days so that they can demonstrate new technology at various exhibits for Emergency Response and Homeland Security Organizations. The first exhibit is in Tampa, Florida from June 6—9". The earth station will transmit a digital data carrier for the demonstrations. The Globecomm Systems Inc. Ku—band terminal uses an AvL Technologies, Model 9066K antenna with a dimension of 90 x 66 cm (an equivalent aperture of 0.75 meters). Exhibit No. Identify all exhibits that are attached to this application. Radiation Hazard Non—Compliant Antenna Statement Affidavit Letter Antenna Pattern CERTIFICATION The Applicant waives any claim to the use of any particular frequency or of the electromagnetic spectrum as against the regulatory power of the United States because of the previous use of the same, whether by license or otherwise, and requests an authorization in accordance with this application. The applicant certifies that grant of this application would not cause the applicant to be in violation of the spectrum aggregation limit in 47 CFR Part 20. All statements made in exhibits are a material part hereof and are incorporated herein as if set out in full in this application. The undersigned, individually and for the applicant, hereby certifies that all statements made in this application and in all attached exhibits are true, complete and correct to the best of his or her knowledge and belief, and are made in good faith. 44. Applicant is a (an): (Place an "X" in the box next to applicable response.) [] a. Individual [_] b. Unincorporated Association [_] c. Partnership [d. Corporation [Je. Governmental Entity [_] e. Other (Please specify) FCC 312, Main Form—Page 4 February, 1998

45. Typed Name of Person Signing 46. Title of Person Signing Kenneth A. Miller President *"~"21 O MJl *Toony WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Title 18, Section 1001), AND/OR REVOCATION OF ANY STATION AUTHORIZATION (U.S. Code, Title 47, Section 312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, Section 503). FCC 312, Main Form—Page 5 February, 1998


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Document Modified: 2005-05-17 14:02:00
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