Application Form [pdf]

This document pretains to SAT-STA-20140925-00104 for Special Temporal Authority on a Satellite Space Stations filing.

IBFS_SATSTA2014092500104_1062934

                                                                                                                Approved by OMB
                                                                                                                       3060−0678

Date & Time Filed: Sep 25 2014 3:53:44:793PM
File Number: SAT−STA−20140925−00104
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:
Request for Further Extension of 30−Day Special Temporary Authority to Drift Intelsat 5, Call Sign S2704
1. Applicant

           Name:        Intelsat License LLC            Phone Number:                   703−559−7848
           DBA Name:                                    Fax Number:                     703−559−8539
           Street:      c/o Intelsat Corporation        E−Mail:                         susan.crandall@intelsat.com
                        7900 Tysons One Place
           City:        McLean                          State:                           VA
           Country:     USA                             Zipcode:                        22102       −5972
           Attention:   Susan H. Crandall




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2. Contact

             Name:         Susan H. Crandall                    Phone Number:                         703−559−7848
             Company:      Intelsat Corporation                 Fax Number:                           703−559−8538
             Street:       7900 Tysons One Place                E−Mail:                               susan.crandall@intelsat.com



             City:         McLean                               State:                                VA
             Country:        USA                                Zipcode:                              22102      −5972
             Attention:    Susan H. Crandall                    Relationship:                         Legal Counsel


(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 SATMOD2012100200176 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    CRY − Space Station (Geostationary)
5. Type Request

    Change Station Location                           Extend Expiration Date                            Other


6. Temporary Orbit Location                                                7. Requested Extended Expiration Date
                                                                                2014−10−28 00:00:00.0




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8. Description   (If the complete description does not appear in this box, please go to the end of the form to view it in its entirety.)
       Intelsat License LLC herein requests an additional 30 days, from September 29, 2014
       through October 28, 2014, of the Special Temporary Authority previously granted Intelsat
       to drift Intelsat 5 (call sign S2704) from 50.15 E.L. to 157.0 E.L.




9. By checking Yes, the undersigned certifies that neither applicant nor any other party to the application is subject         Yes         No
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.


10. Name of Person Signing                                                  11. Title of Person Signing
Susan H. Crandall                                                           Assoc. General Counsel, Intelsat Corporation
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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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.




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Document Created: 2019-04-11 00:07:51
Document Modified: 2019-04-11 00:07:51

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