Application Form SAT-STA-20190924-00098

Application Form

This document pretains to SAT-STA-20190924-00098 for Special Temporal Authority on a Satellite Space Stations filing.

Approved by OMB
3060-0678

Date & Time Filed: Sep 24 2019 4:07:10:780PM
File Number: SAT-STA-20190924-00098
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:

Respacing MOD STA Request

1. Applicant

Name:	Space Exploration Holdings, LLC	Phone Number:	202-649-2700
DBA Name:		Fax Number:	202-649-2701
Street:	1155 F Street, N.W.	E-Mail:	patricia.cooper@spacex.com
	Suite 475
City:	Washington	State:	DC
Country:	USA	Zipcode:	20004 -
Attention:	Ms Patricia Cooper

2. Contact

Name:	William M. Wiltshire	Phone Number:	202-730-1350
Company:	Harris, Wiltshire & Grannis LLP	Fax Number:	202-730-1301
Street:	1919 M Street, NW	E-Mail:	wwiltshire@hwglaw.com
	Suite 800
City:	Washington	State:	DC
Country:	USA	Zipcode:	20036 -
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 SATMOD2019083000087 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 SpaceX requests a 60-day STA to place spacecraft in the orbital planes requested in its pending modification and to communicate with gateway earth stations during early operations while the Commission is considering the underlying applications.

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
Patricia Cooper

11. Title of Person Signing
Vice President, Satellite Government Affairs

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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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.