Application Form SAT-STA-20160205-00011

Application Form

This document pretains to SAT-STA-20160205-00011 for Special Temporal Authority on a Satellite Space Stations filing.

Approved by OMB
3060-0678

Date & Time Filed: Feb 5 2016 12:25:02:826PM
File Number: SAT-STA-20160205-00011
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:

STA for AMC-12 (S2415) Stationkeeping Correction

1. Applicant

Name:	SES Americom, Inc.	Phone Number:	202-478-7144
DBA Name:		Fax Number:	202-478-7111
Street:	1129 20th Street NW	E-Mail:	nancy.eskenazi@ses.com
	Suite 1000
City:	Washington	State:	DC
Country:	USA	Zipcode:	20036 -
Attention:	Ms. Nancy J. Eskenazi

2. Contact

Name:	Karis Hastings	Phone Number:	202-599-0975
Company:	SatCom Law LLC	Fax Number:
Street:	1317 F Street, N.W.	E-Mail:	karis@satcomlaw.com
	Suite 400
City:	Washington	State:	DC
Country:	USA	Zipcode:	20004 -
Attention:		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 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

8. Description SES Americom, Inc. requests special temporary authority through February 15, 2016, to permit operations of the AMC-12 space station slightly outside its assigned stationkeeping volume.

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 Eskenazi

11. Title of Person Signing
Vice President

12. Please supply any need attachments.

Attachment 1: STA Narrative

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.