Attachment Form 159

This document pretains to SAT-AMD-20040312-00034 for Amended Filing on a Satellite Space Stations filing.

IBFS_SATAMD2004031200034_368764

READ INSTRUCTIONS CAREFULLY Approved by OMB BEFORE PROCEEDING FEDERAL COMMUNICATIONS COMMISSION 30600589 REMITTANCE ADVICE Page 1- 0.J SECTION A - PAYERINFORMATION .. (2) PAYER NAME (if oavine bv credit card enter name exactlv as i t amears onthe card) I (3) TOTAL AMOUNT PAID (U S Dollars and cents) I . . _ L _ Northrop Grumman Space & Missi . $1,410.00 I (4) STREET ADDRESS LINE NO 1 1000 Wilson Blvd. (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) (10) COUNTRY CODE (ifn0tinU.S.A.) 703 - 7417717 us FCC REGISTRATION NUMBER IFRN) REQUIRED . ( I I ) PA\ t R (FR\) ( 12) FCC USE QNLY %LA*, . * . 0004843553 % . I b MORE THAN ONE APPLICANI. USE CONTI\UATION SHEETS (FORM 159-C) COMPLETE SECTION BELOW FOR EACH SERVICE, IF MORE BOXES ARE NEEDED, USE CONTINUATION SHEET (13)APPLICANTNAME Northrop Grumman Space & Mission Svstems Corm (14) STREET ADDRESS LINE NO 1 1000 Wilson Blvd. (15) STREET ADDRESS LINE NO. 2 Suite 2300 (16) CITY (I7)STATE (18)ZIPCODE Arlinaton VA 22209 - (19) DAYTIME TELEPHONE NUMBER (include area code) (20) COUNTRY CODE (ifnot in U S A ) 703-741-7717 us FCC REGISTRATION NUMBER (FRN) REQUIRED COMPLETE SECTION C FOR EACH SERVICE, IF MORE BOXES ARE NEEDED, USE CONTINUATION SHEET (23A) CALL SIGN/OTHER ID (24A) PAYMENT TYPE CODE (25A) QUANTITY CWY 1 I. ( 2 6 A ) FEE D L E FOR (PTCI (27AlTOTAL FEE 2 $1.410.00 $1,410.00 128A) FCC CODE I I 1B2004000569 (23B)CALL SlGNiOTHER ID (24B) PAYMENT TYPE CODE ( 2 5 8 ) QUANTITY I SECTION D - CERTIFICATION penalty ofperjury that the foregoing and supportmg information is true and correct to DATEAT - I S - 2~ I!# SECTION E -CREDIT CARD PAYMENT INFORMATION MASTERCARD-- VISA--- AMEX- DISCOVER- ACCOUNT NUMBER EXPIRATION DATE I hereby authorize the FCC to charge my credit card for the service(s)/authorizatim herein described SIGNATURE DATE SEE PUBLIC BURDEN ON REVERSE FCC FORM 159 FEBRUARY 2003(REVlSED)


Document Created: 2004-03-25 15:12:54
Document Modified: 2004-03-25 15:12:54
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