Application Form [pdf]

This document pretains to ITC-STA-20130912-00258 for Special Temporal Authority on a International Telecommunications filing.

IBFS_ITCSTA2013091200258_1012207

                                                                                                            Approved by OMB
                                                                                                                   3060−0686


                      INTERNATIONAL SECTION 214 SPECIAL TEMPORARY AUTHORITY APPLICATION
                                                     FCC FORM 214STA
                                             FOR OFFICIAL USE ONLY

           APPLICANT INFORMATION Enter a description of this application to identify it on the main menu:
 Special Temporary Authority to Transfer Control of Epsilon Telecommunications to Andreas Hipp
1. Applicant

         Name:         Epsilon Telecommunications (US) Phone Number:                +65 3106 4020
                       Pte. Ltd.
         DBA Name:                                   Fax Number:                    +65 6281 0470
         Street:       151 Lorong Chuan              E−Mail:                        m.lee@epsilontel.com


         City:         Singapore                     State:
         Country:      Singapore                     Zipcode:                       −
         Attention:    Marianne Lee




1


2. Contact

          Name:           Jean Kiddoo and Danielle Burt         Phone Number:         202−373−6000
          Company:        Bingham McCutchen LLP                 Fax Number:           202−373−6001
          Street:         2020 K Street, N.W.                   E−Mail:               danielle.burt@bingham.com


          City:           Washington                            State:                DC
          Country:         USA                                  Zipcode:              20006   −1806
          Contact Title: Jean Kiddoo and Danielle Burt          Relationship:         Legal Counsel


    3. Place of Incorporation of ApplicantSingapore
 4. Other Company(ies) and Place(s) of Incorporation


5. Service Type(s) (check all that apply)
    Global or Limited Global Facilities−Based Authority (Section 63.18(e)(1))
    Global or Limited Global Resale Authority (Section 63.18(e)(2))
    Individual Facilities−Based Service (Section 63.18(e)(3))
    Individual Switched Resale Service (Section 63.18(e)(3))
    Individual Facilities−Based and Resale Service (Section 63.18(e)(3))
    Switched Services over Private Lines (ISR) (Section 63.16 and/or 63.18 (e)(3))
    Inmarsat and Mobile Satellite Service (Section 63.18(e)(3))
    Overseas Cable Construction (Section 63.18(e)(3))
    Individual Non−Interconnected Private Line Resale Service (Section 63.18(e)(3))
    Other (Section 63.18(e)(3))




2


     TYPE OF REQUEST
     6.       New Request          Extend STA Date           Other              7. Date Authorization Needed:09/12/2013


8.            Is a fee submitted with this application?
          If Yes, complete and attach FCC Form 159. If No, indicate reason for fee exemption (see 47 C.F.R.Section 1.1114).
          Governmental Entity      Noncommercial educational licensee
          Other(please explain):

9. Description of Special Temporary Authority Requested.
(If the complete description does not appear in this box, please go to the end of the form to view it in its entirety.)
                         Special Temporary Authority to Transfer Control of Epsilon
                         Telecommunications to Andreas Hipp




10. In Attachment 1, provide justification of need for special temporary authority requested.


11. If this request for Special Temporary Authority is associated with any pending applications filed with the Commission, enter either the file
number [e.g., ITC−214−19930101−23412] or the IB Submission ID of the pending application [e.g., IB200311111] AND go to question 16.)
File Number or Submission ID IB2013001988
Applicant certifies that its responses to questions 11 through 17 are true:

    12. If the applicant is a foreign carrier, or is affiliated (as defined in 47 C.F.R. Section 63.09(e)) with a foreign carrier, provide in Attachment 1
    the information and certifications required by Section 63.18(i) through (m).




3


13. Does the applicant seek authority to provide service to any destination described in paragraphs (1) through (4)          Yes            No
of Section 63.18(j)? If yes, list those destinations in Attachment 1 as a response to question 12.



14. Does the applicant seek authority to provide service to any destinations other than those listed in response to          Yes            No
question 12 where it has an affiliation with a foreign carrier? If yes, list those destinations in Attachment 1 as a
response to question 13.



    15. [Section 63.18(h)] In Attachment 2, provide the name, address, citizenship and principal business of the applicant ’s ten percent or greater
    direct and indirect shareholders or other equity holders, and identify any interlocking directorates.



    16. In Attachment 1, respond to paragraphs (d), (e)(3) and (g) of Section 63.18.



17. By checking Yes, the undersigned certifies that neither applicant nor any other party to the application is              Yes            No
subject to a denial of Federal benefits that includes FCC benefits pursuant to Section 5301 of the Anti−Drug Act of
1988, 21 U.S.C. Section 862, because 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.



18. By checking Yes, the applicant certifies that it has not agreed to accept special concessions directly or                Yes            No
indirectly from a foreign carrier with respect to any U.S. international route where the foreign carrier possesses
sufficient market power on the foreign end of the route to affect competition adversely in the U.S. market and will
not enter into such agreements in the future.




4


    CERTIFICATION
19. Typed Name of Person Signing                                           20. Title of Person Signing
Jerzy Szlosarek                                                            Director
          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).



         21.1:    STA Request                        2:    1                                      3:




FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT

The public reporting for this collection of information is estimated to average 8 hours per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the required data, and completing and reviewing the collection of information. If you
have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you, please write to the Fede
ral Communications Commission, AMD−PERM, Paperwork Reduction Project (3060−0686), Washington, DC 20554. We will also accept your
comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to PRA@fcc.gov. PLEASE DO
NOT SEND YOUR RESPONSE TO THIS ADDRESS.

Remember − You are not required to respond to a collection of information sponsored by the Federal government,and the government may not
conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This
collection has been assigned an OMB control number of 3060−0686.

THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104−13, OCTOBER
1, 1995, 44 U.S.C. SECTION 3507.




5



Document Created: 2019-04-15 09:50:49
Document Modified: 2019-04-15 09:50:49

© 2024 FCC.report
This site is not affiliated with or endorsed by the FCC