Application Form

This document pretains to SAT-STA-20201110-00133 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
Intelsat License LLC, as debtor-in-possession 703-559-7848
703-559-8539
7900 Tysons One Place susan.crandall@intelsat.com
McLean VA
USA 22101 -5972
Susan H. Crandall
2. Contact
Cynthia J. Grady 703-559-6949
Intelsat US LLC 703-559-8539
7900 Tysons One Place cynthia.grady@intelsat.com
McLean VA
USA 22102 -5972
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 SATMOD2020090900106 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 Intelsat herein requests an additional 60 days of Special Temporary Authority to operate the Galaxy 12 satellite's C-band beams over a new coverage area in the communications frequencies 3700-4200 MHz in order to provide customer service.
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
Cynthia J. Grady		 11. Title of Person Signing
Senior Counsel, Intelsat US LLC
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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