Narrative

0079-EX-ST-2019 Text Documents

Maris Developments

2019-01-30ELS_222137

Agency Tracking ID:PGC3203431 Authorization Number:235114 Successful Authorization -- Date Paid: 1/30/19 FILE COPY ONLY!! READ INSTRUCTIONS FEDERAL COMMUNICATIONS COMMISSION APPROVED BY OMB CAREFULLY BEFORE REMITTANCE ADVICE SPECIAL USE 3060-059 PROCEEDING FORM 159 PAGE NO 1 OF 1 FCC USE ONLY (1) LOCKBOX #979095 SECTION A - Payer Information (3) TOTAL AMOUNT PAID (dollars and cents) (2) PAYER NAME (if paying by credit card, enter name exactly as it appears on your card) $70.00 Henry Gola (4) STREET ADDRESS LINE NO. 1 2011 N Lexington St (5) STREET ADDRESS LINE NO. 2 (6) CITY (7) STATE (8) ZIP CODE Arlington VA 22205 (9) DAYTIME TELEPHONE NUMBER (INCLUDING AREA CODE) (10) COUNTRY CODE (IF NOT IN U.S.A.) 804-8875049 US FCC REGISTRATION NUMBER (FRN) AND TAX IDENTIFICATION NUMBER (TIN) REQUIRED (11) PAYER (FRN) (12) FCC USE ONLY 0022925945 IF PAYER NAME AND THE APPLICANT NAME ARE DIFFERENT, COMPLETE SECTION B IF MORE THAN ONE APPLICANT, USE CONTINUATION SHEETS (FORM 159-C) (13) APPLICANT NAME Maris Developments (14) STREET ADDRESS LINE NO. 1 Brian Matthews (15) STREET ADDRESS LINE NO. 2 251 Little Falls DR. (16) CITY (17) STATE (18) ZIP CODE Wilmington DE 19808 (19) DAYTIME TELEPHONE NUMBER (INCLUDING AREA CODE) (20) COUNTRY CODE (IF NOT IN U.S.A.) 7037265671 US FCC REGISTRATION NUMBER (FRN) AND TAX IDENTIFICATION NUMBER (TIN) REQUIRED (21) APPLICANT (FRN) (22) FCC USE ONLY 0027737741 COMPLETE SECTION C FOR EACH SERVICE, IF MORE BOXES ARE NEEDED, USE CONTINUATION SHEET (23A) FCC Call Sign/Other ID (24A) Payment Type Code(PTC) (25A) Quantity 0079ST2019 EAE 1 (26A) Fee Due for (PTC) (27A) Total Fee FCC Use Only $70.00 $70.00 (28A) FCC CODE 1 (29A) FCC CODE 2 13EL355603 (23B) FCC Call Sign/Other ID (24B) Payment Type Code(PTC) (25B) Quantity (26B) Fee Due for (PTC) (27B) Total Fee FCC Use Only (28B) FCC CODE 1 (29B) FCC CODE 2


Document Created: 2019-01-30 20:11:55
Document Modified: 2019-01-30 20:11:55
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