Application Form SAT-STA-20040414-00083

Application Form

This document pretains to SAT-STA-20040414-00083 for Special Temporal Authority on a Satellite Space Stations filing.

Approved by OMB
3060-0678

Date & Time Filed: Apr 14 2004 2:47:22:470PM
File Number: SAT-STA-20040414-00083
Callsign:

FEDERAL COMMUNICATIONS COMMISSION
APPLICATION FOR SPACE STATION SPECIAL TEMPORARY AUTHORITY

FOR OFFICIAL USE ONLY

APPLICANT INFORMATION

Enter a description of this application to identify it on the main menu:

AMC-11 STA (146 WL)request 4-2004

1. Applicant

Name:	SES Americom, Inc.	Phone Number:	609-987-4187
DBA Name:		Fax Number:	609-987-4233
Street:	Four Research Way	E-Mail:	nancy.eskenazi@ses-americom.com

City:	Princeton	State:	NJ
Country:	USA	Zipcode:	08540 -6684
Attention:	Nancy J. Eskenazi

2. Contact

Name:	Karis A. Hastings	Phone Number:	202-637-5767
Company:	Hogan & Hartson L.L.P.	Fax Number:	202-637-5910
Street:	555 Thirteenth Street, NW	E-Mail:	KAHastings@HHLaw.com

City:	Washington	State:	DC
Country:	USA	Zipcode:	20004 -1109
Contact Title:		Relationship:	Legal Counsel

(If your application is related to an application filed with the Commission, enter the file number below.)
3. Reference File Number

4a. 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):

4b. Fee Classification CRY - Space Station (Geostationary)

5. Type Request

Change Station Location

Extend Expiration Date

Other

6. Temporary Orbit Location

7. Requested Extended Expiration Date

8. Description SES AMERICOM, Inc. respectfully requests special temporary authority to permit it to test its AMC-11 spacecraft at 146 degrees W.L.

9. By checking Yes, the undersigned certifies that neither applicant nor any other party to the application is 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.

Yes

10. Name of Person Signing
Nancy J. Eskenazi

11. Title of Person Signing
Vice President & Associate General Counsel

12. Please supply any need attachments.

Attachment 1: Att. 1

Attachment 2:

Attachment 3:

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).

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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 3060-0678.

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.