Application Form

This document pretains to SAT-STA-20090721-00074 for Special Temporal Authority on a Satellite Space Stations filing.

Approved by OMB
3060-0678

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:
1. Applicant
Sirius XM Radio Inc. 212-584-5100
212-584-5353
1221 Avenue of the Americas
36th Floor
New York NY
USA 10020 -
Mr. Patrick L. Donnelly
2. Contact
James S. Blitz 202-380-4000
Sirius XM Radio Inc. 202-380-4981
1500 Eckington Place NE [email protected]
Washington DC
USA 20002 -
Same
(If your application is related to an application filed with the Commission, enter either the file number or the IB Submission ID of the related application. Please enter only one.)
3. Reference File Number
or Submission ID
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 CXW - Space Station (Non-Geostationary)
5. Type Request
Change Station Location Extend Expiration Date Other
6. Temporary Orbit Location
7. Requested Extended Expiration Date
8. Description Sirius XM Radio Inc. requests Special Temporary Authority to operate six new low power terrestrial repeaters at various locations for 180 days pursuant to the technical parameters listed in Exhibit A.
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 No
10. Name of Person Signing
James S. Blitz
11. Title of Person Signing
Vice President, Regulatory Counsel
12. Please supply any need attachments.
Attachment 1: STA Request 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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