Attachment Form 159

This document pretains to SAT-AMD-20040312-00031 for Amended Filing on a Satellite Space Stations filing.

IBFS_SATAMD2004031200031_368759

Approved by OMB READ I.4STRUCTIONS CAREFULLY BEFORE PROCEEDING FEDERAL COMMUNICATIONS COMMISSION , 30600589 REMITTANCE ADVICE (2) PAYER NAME (if paying by credit card enter name exactly as i t appears onthe card) (3) TOTAL AMOUNT PAID (U S Dollars and cents) Northror, Grumman Space & Missi $1.41 0.00 (4) STREET ADDRESS LINE NO I 1000 Wilson Blvd. SAT AVII',-ZCCW?IIZ-K~~ I ( 5 ) STREET ADDRESS LINE NO 2 Suite 2300 (6) CITY (7) STATE (8)ZIP CODE Arlinaton VA 22209 (9) DAYTIME TELEPHONE NUMBER (include area code) (IO)COUNTRYCODE(ifnotinUSA) - 703 7417717 us Northror, Grumman Sr,ace & Mission Svstems Corm (14) STREET ADDRESS LINE NO 1 1000 Wilson Blvd. (15) STREET ADDRESS LINE NO 2 Suite 2300 (16) CITY (I7)STATE (I8)ZIPCODE Arlinaton VA 22209 - (19) DAYTIME TELEPHONE NUMBER (include area code) (20) COUNTRY CODE (if not in U S A ) 703-741-7717 us FCC REGISTRATION NUMBER IFRN) REOUIRED (2 I ) APPLICA\T(FRNI (22)FCC USfi ONLY 0004843553 COMPLETE SECTION C FOR EACH SER\ ICE. IF 'MORE BOXES ARE \EEDED, USE COYTINUATION SHEET (23A) CALL SIGN/OTHER ID (24A) PAYMENT TYPE CODE (2SA) QUANTITY CWY 1 I lB2004000566 (23B) CALL SIGNIOTHER ID (24B) PAYMENT TYPE CODE (25B) QUANTITY alty ofperjury that the foregoing and supporting information is true dnd correct to SIGNATURE DATE- oc? - /%x- 7 SECTION E - CREDIT CARD PAYMENT INFORMATION MASTERCARD-- VISA--- AMEX- DISCOVER- ACCOUNT NUMBER EXPIRATION DATE 1 hereby authorize the FCC to charge mycredit card for the service(s)/authorizaticn herem described SIGNATURE DATE SEE PUBLIC BURDEN ON REVERSE FCC FORM 159 FEBRUARY 2003(REVISED)


Document Created: 2004-03-25 15:12:04
Document Modified: 2004-03-25 15:12:04
© 2024 FCC.report
This site is not affiliated with or endorsed by the FCC