Application Form [pdf]

This document pretains to SES-LIC-20150928-00638 for License on a Satellite Earth Station filing.

IBFS_SESLIC2015092800638_1105786

                                                                                                     Approved by OMB
                                                                                                            3060−0678

Date & Time Filed: Sep 28 2015 2:16:06:683PM
File Number: SES−LIC−INTR2015−01767
Callsign/Satellite ID:


                    APPLICATION FOR EARTH STATION AUTHORIZATIONS                     FCC Use Only

                                      FCC 312 MAIN FORM
                                    FOR OFFICIAL USE ONLY

APPLICANT INFORMATION
Enter a description of this application to identify it on the main menu:
Blanket License for a Ku−band VSAT Network of fixed and transportable remotes
1−8. Legal Name of Applicant

          Name:         BT Americas Inc.              Phone Number:             703−755−6733
          DBA                                         Fax Number:               703−755−6740
          Name:
          Street:       11440 Commerce Park Drive     E−Mail:                   linda.cicco@bt.com
                        Suite 100
          City:         Reston                        State:                    VA
          Country:      USA                           Zipcode:                  20191       −
          Attention:    Ms Linda J Cicco




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9−16. Name of Contact Representative

          Name:        Ms Linda J Cicco            Phone Number:   703−755−6733
          Company: BT Americas Inc.                Fax Number:     703−755−6740
          Street:      11440 Commerce Park Drive   E−Mail:         linda.cicco@bt.com
                       Suite 100
          City:        Reston                      State:          VA
          Country:      USA                        Zipcode:        20191−
          Attention:                               Relationship:




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CLASSIFICATION OF FILING
    17. Choose the button next to the                b.
    classification that applies to this filing for          b1. Application for License of New Station
    both questions a. and b. Choose only one
                                                            b2. Application for Registration of New Domestic Receive−Only Station
    for 17a and only one for 17b.
                                                     (N/A) b3. Amendment to a Pending Application
    a.                                               (N/A) b4. Modification of License or Registration
          a1. Earth Station                          (N/A) b5. Assignment of License or Registration
                                                     (N/A) b6. Transfer of Control of License or Registration
    (N/A) a2. Space Station                          (N/A) b7. Notification of Minor Modification
                                                     (N/A) b8. Application for License of New Receive−Only Station Using Non−U.S. Licensed
                                                     Satellite
                                                     (N/A) b9. Letter of Intent to Use Non−U.S. Licensed Satellite to Provide Service in the United
                                                     States
                                                          b10. Other (Please specify)
                                                            b11. Application for Earth Station to Access a Non−U.S.satellite Not Currently Authorized to
                                                     Provide the Proposed Service in the Proposed Frequencies in the United States.
                                                           b12. Application for Database Entry
                                                          (N/A) b13. Amendment to a Pending Database Entry Application
                                                          (N/A) b14. Modifiction of Database Entry
         17c. 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):

    17d.

    Fee Classification BGV − Fixed Satellite VSAT System




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    18. If this filing is in reference to an   19. If this filing is an amendment to a pending application enter:
    existing station, enter:
                                               (a) Date pending application was filed:            (b) File number of pending application:
    (a) Call sign of station:
    Not Applicable                             Not Applicable                                     Not Applicable



TYPE OF SERVICE
20. NATURE OF SERVICE: This filing is for an authorization to provide or use the following type(s) of service(s): Select all that apply:


       a. Fixed Satellite
       b. Mobile Satellite
       c. Radiodetermination Satellite
       d. Earth Exploration Satellite
       e. Direct to Home Fixed Satellite
       f. Digital Audio Radio Service
       g. Other (please specify)

21. STATUS: Choose the button next to the applicable status. Choose        22. If earth station applicant, check all that apply.
only one.                                                                       Using U.S. licensed satellites
      Common Carrier        Non−Common Carrier                                  Using Non−U.S. licensed satellites

23. If applicant is providng INTERNATIONAL COMMON CARRIER service, see instructions regarding Sec. 214 filings. Choose one. Are these
facilities:
           Connected to a Public Switched Network Not connected to a Public Switched Network     N/A




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    24. FREQUENCY BAND(S): Place an "X" in the box(es) next to all applicable frequency band(s).
      a. C−Band (4/6 GHz)  b. Ku−Band (12/14 GHz)
      c.Other (Please specify upper and lower frequencies in MHz.)
        Frequency Lower: Frequency Upper:


TYPE OF STATION
25. CLASS OF STATION: Choose the button next to the class of station that applies. Choose only one.
          a. Fixed Earth Station
          b. Temporary−Fixed Earth Station
          c. 12/14 GHz VSAT Network
          d. Mobile Earth Station
(N/A) e. Geostationary Space Station
(N/A) f. Non−Geostationary Space Station
         g. Other (please specify)


26. TYPE OF EARTH STATION FACILITY: Choose only one.
      Transmit/Receive Transmit−Only  Receive−Only                    N/A


PURPOSE OF MODIFICATION

27. The purpose of this proposed modification is to: (Place an ’X’ in the box(es) next to all that apply.)


Not Applicable




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ENVIRONMENTAL POLICY

28. Would a Commission grant of any proposal in this application or amendmenthave a significant                              Yes        No
environmental impact as defined by 47 CFR 1.1307? If YES, submit thestatement as required by Sections
1.1308 and 1.1311 of the Commission’s rules,47 C.F.R. §§ 1.1308 and 1.1311, as an exhibit to this                      Radhaz
application.A Radiation Hazard Studymust accompany all applications for new transmitting facilities, major
modifications,or major amendments.



ALIEN OWNERSHIP Earth station applicants not proposing to provide broadcast, common carrier, aeronautical en route or
aeronautical fixed radio station services are not required to respond to Items 30−34.

29. Is the applicant a foreign government or the representative of any foreign government?                             Yes         No




30. Is the applicant an alien or the representative of an alien?                                                       Yes         No   N/A




31. Is the applicant a corporation organized under the laws of any foreign government?                                 Yes         No   N/A




32. Is the applicant a corporation of which more than one−fifth of the capital stock is owned of record or voted by    Yes         No   N/A
aliens or their representatives or by a foreign government or representative thereof or by any corporation organized
under the laws of a foreign country?




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33. Is the applicant a corporation directly or indirectly controlled by any other corporation of which more than          Yes         No   N/A
one−fourth of the capital stock is owned of record or voted by aliens, their representatives, or by a foreign
government or representative thereof or by any corporation organized under the laws of a foreign country?



34. If any answer to questions 29, 30, 31, 32 and/or 33 is Yes, attach as an exhibit an identification of the aliens or
foreign entities, their nationality, their relationship to the applicant, and the percentage of stock they own or vote.



BASIC QUALIFICATIONS

35. Does the Applicant request any waivers or exemptions from any of the Commission’s Rules?                                    Yes        No
If Yes, attach as an exhibit, copies of the requests for waivers or exceptions with supporting documents.




36. Has the applicant or any party to this application or amendment had any FCC station authorization or license                Yes        No
revoked or had any application for an initial, modification or renewal of FCC station authorization, license, or
construction permit denied by the Commission? If Yes, attach as an exhibit, an explination of circumstances.




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37. Has the applicant, or any party to this application or amendment, or any party directly or indirectly controlling    Yes   No
the applicant ever been convicted of a felony by any state or federal court? If Yes, attach as an exhibit, an
explination of circumstances.




38. Has any court finally adjudged the applicant, or any person directly or indirectly controlling the applicant,        Yes   No
guilty of unlawfully monopolizing or attemptiing unlawfully to monopolize radio communication, directly or
indirectly, through control of manufacture or sale of radio apparatus, exclusive traffic arrangement or any other
means or unfair methods of competition?If Yes, attach as an exhibit, an explanation of circumstances




39. Is the applicant, or any person directly or indirectly controlling the applicant, currently a party in any pending   Yes   No
matter referred to in the preceding two items? If yes, attach as an exhinit, an explanation of the circumstances.




40. If the applicant is a corporation and is applying for a space station license, attach as an exhibit the names,
address, and citizenship of those stockholders owning a record and/or voting 10 percent or more of the Filer’s
voting stock and the percentages so held. In the case of fiduciary control, indicate the beneficiary(ies) or class of
beneficiaries. Also list the names and addresses of the officers and directors of the Filer.




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



42a. Does the applicant intend to use a non−U.S. licensed satellite to provide service in the United States? If Yes,            Yes          No
answer 42b and attach an exhibit providing the information specified in 47 C.F.R. 25.137, as appropriate. If No,
proceed to question 43.




42b. What administration has licensed or is in the process of licensing the space station? If no license will be issued, what administration has
coordinated or is in the process of coordinating the space station?




43. Description. (Summarize the nature of the application and the services to be provided).                      (If the complete description does
not appear in this box, please go to the end of the form to view it in its entirety.)
    Blanket License for a Ku−band VSAT−network consisting of 1.2 meter and 1.8 meter fixed
    remotes and 1.2 meter transportable fixed remotes. The proposed VSAT network will provide
    support to the applicant’s client base.




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43a. Geographic Service Rule Certification                                                                                        A
By selecting A, the undersigned certifies that the applicant is not subject to the geographic service or geographic
coverage requirements specified in 47 C.F.R. Part 25.
                                                                                                                                  B
By selecting B, the undersigned certifies that the applicant is subject to the geographic service or geographic
coverage requirements specified in 47 C.F.R. Part 25 and will comply with such requirements.
                                                                                                                                  C
By selecting C, the undersigned certifies that the applicant is subject to the geographic service or geographic
coverage requirements specified in 47 C.F.R. Part 25 and will not comply with such requirements because it is not
feasible as a technical matter to do so, or that, while technically feasible, such services would require so many
compromises in satellite design and operation as to make it economically unreasonable. A narrative description
and technical analysis demonstrating this claim are attached.




CERTIFICATION
The Applicant waives any claim to the use of any particular frequency or of the electromagnetic spectrum as against the regulatory power of the
United States because of the previous use of the same, whether by license or otherwise, and requests an authorization in accordance with this
application. The applicant certifies that grant of this application would not cause the applicant to be in violation of the spectrum aggregation limit
in 47 CFR Part 20. All statements made in exhibits are a material part hereof and are incorporated herein as if set out in full in this application.
The undersigned, individually and for the applicant, hereby certifies that all statements made in this application and in all attached exhibits are
true, complete and correct to the best of his or her knowledge and belief, and are made in good faith.




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44. Applicant is a (an): (Choose the button next to applicable response.)

      Individual
      Unincorporated Association
      Partnership
      Corporation
      Governmental Entity
      Other (please specify)




     45. Name of Person Signing                                             46. Title of Person Signing
     Ms Linda J Cicco                                                       Regulatory Compliance Manager


47. Please supply any need attachments.
 Attachment 1:                                    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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                                          SATELLITE EARTH STATION AUTHORIZATIONS
                                   FCC Form 312 − Schedule B:(Technical and Operational Description)
                                                      FOR OFFICIAL USE ONLY



Location of Earth Station Site

E1: Site Identifier: VSAT Fixed         E5. Call Sign:
E2: Contact Name Linda Cicco            E6. Phone          703 755−6733
                                        Number:
E3. Street:                             E7. City:
                                        E8. County:
E4. State                               E9. Zip Code

E10. Area of Operation:                 U.S. CONUS, Alaska and Hawaii
E11. Latitude:       0 °0 ’0.0 "
E12. Longitude:      0 °0 ’0.0 "
E13. Lat/Lon Coordinates are:              NAD−27             NAD−83              N/A


E14. Site Elevation (AMSL):             0.0 meters




12


E15. If the proposed antenna(s) operate in the Fixed Satellite Service (FSS) with geostationary satellites, do(es) the
proposed antenna(s) comply with the antenna gain patterns specified in Section 25.209(a) and (b) as demonstrated         Yes   No        N/A
by the manufacturer’s qualification measurement? If NO, provide as a technical analysis showing compliance with
two−degree spacing policy.


E16. If the proposed antenna(s) do not operate in the Fixed Satellite Service (FSS), or if they operate in the Fixed
Satellite Service (FSS) with non−geostationary satellites, do(es) the proposed antenna(s) comply with the antenna        Yes   No        N/A
gain patterns specified in Section 25.209(a2) and (b) as demonstrated by the manufacturer’s qualification
measurements?


E17. Is the facility operated by remote control? If YES, provide the location and telephone number of the control
point.                                                                                                                   Yes        No




E18. Is frequency coordination required? If YES, attach a frequency coordination report as
                                                                                                                         Yes        No


E19. Is coordination with another country required? If YES, attach the name of the country(ies) and plot of
coordination contours as                                                                                                 Yes        No


E20. FAA Notification − (See 47 CFR Part 17 and 47 CFR part 25.113(c)) Where FAA notification is required, have
you attached a copy of a completed FCC Form 854 and or the FAA’s study regarding the potential hazard of the             Yes        No
structure to aviation?
FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS
APPLICATION.
 POINTS OF COMMUNICATION
Satellite Name:    PERMITTED LIST | | If you selected OTHER, please enter the following:




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E21. Common Name:                                                    E22. ITU Name:
E23. Orbit Location:                                                 E24. Country:
     POINTS OF COMMUNICATION (Destination Points)
E25. Site Identifier:
E26. Common Name:                                                    E27. Country:
 ANTENNA
Site ID                 E28. Antenna Id    E29. Quantity    E30.              E31. Model         E32. Antenna      E41/42. Antenna
                                                            Manufacturer                         Size<meters>      GainTransmint
                                                                                                                   and/or Recieve
                                                                                                                   (____dBi at
                                                                                                                   _____GHz)
VSAT Fixed              1.2m Fixed         50               General Dynamics 1132−992            1.2               41.4 dBi at 11.95


                                                                                                                   43.3 dBi at 14.25


                        1.8m fixed                                            1194               1.8               45.2 dBi at 11.95


                                                                                                                   46.7 dBi at 14.25



E28. Antenna       E33/34.           E35. Above       E36. Above Sea E37. Building    E38. Total       E39.             E40. Total
Id                 Diameter          Ground           Level<BR>      Height Above     Input Power at   Maximum          EIRP for al
                   Minor/Major       Level<BR>        (meters)       Ground           antenna          Antenna Height   carriers<BR>
                   (meters)          (meters)                        Level<BR>        flange<BR>       Above            (dBW)
                                                                     (meters)         (Watts)          Rooftop<BR>
                                                                                                       (meters)
1.2m Fixed         0.0/0.0           1.2              1.2            0.0              4.0              0.0              49.32
1.8m fixed         0.0/0.0           1.8              1.8            0.0              4.0              0.0              52.72


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FREQUENCY
E28. Antenna Id    E43/44.         E45. T/R Mode          E46. Antenna      E47. Emission             E48. Maximum     E49. Maximum
                   Frequency Bands                        Polarization(H,V, Designator                EIRP per Carrier ERIP Density per
                   (MHz)                                  L,R)                                        (dBW)            Carrier
                                                                                                                       (dBW/4kHz)
1.2m Fixed         11700            R                     Linear and Circular 930KG7D                 0.0                   0.0
                   12200
E50. Modulation and Services   (If the complete description does not appear in this box, please go to the end of the form to view it in its
entirety.)
     Digital Data Carrier




1.2m Fixed         14000            T                     Linear and Circular 930KG7D                 48.0                  24.3
                   14500
E50. Modulation and Services   (If the complete description does not appear in this box, please go to the end of the form to view it in its
entirety.)
     Digital Data Carrier




1.8m fixed         11700            R                     Linear and Circular 930KG7D                 0.0                   0.0
                   12200




15


E50. Modulation and Services    (If the complete description does not appear in this box, please go to the end of the form to view it in its
entirety.)
     Digital Data Carrier




1.8m fixed         14000             T                     Linear and Circular 930KG7D                 48.0                  24.3
                   14500
E50. Modulation and Services    (If the complete description does not appear in this box, please go to the end of the form to view it in its
entirety.)
     Digital Data Carrier




FREQUENCY COORDINATION
E28.           E51. Satellite E52/53.     E54/55.            E56. Earth       E57.             E58. Earth       E59.                E60.
Antenna Id     Orbit Type     Frequency   Range of           Station          Antenna          Station          Antenna             Maximum
                              Limits(MHz) Satellite Arc      Azimuth          Elevation        Azimuth          Elevation           EIRP Density
                                          E/W Limit          Angle            Angle            Angle            Angle               toward the
                                                             Eastern Limit    Eastern Limit    Western          Western             Horizon
                                                                                               Limit            Limit               (dBW/4kHz)


1.2m Fixed     Geostationary 11700          0.0/ 0.0         0.0              5.0              0.0              5.0                 0.0
                             12200
               Geostationary 14000          0.0/ 0.0         0.0              5.0              0.0              5.0                 −19.0
                             14500




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1.8m fixed         Geostationary 11700            0.0/ 0.0         0.0       5.0             0.0             5.0       0.0
                                 12200
                   Geostationary 14000            0.0/ 0.0         0.0       5.0             0.0             5.0       −22.4
                                 14500
REMOTE CONTROL POINT LOCATION
   E61. Call Sign                                                        E65. Phone Number
   E990541                                                               540 477−5520
   NOTE: Please enter the callsign of the controlling station, not the
callsign for which this application is being filed.
     E62. Street Address
     1305 Industrial Park Rd


     E63. City                                       E67. County                                E64/68.            E66. Zip Code
     Mt. Jackson                                     Shenandoah                              State/Country         22842
                                                                                                VA/ USA




17


                                            SATELLITE EARTH STATION AUTHORIZATIONS
                                     FCC Form 312 − Schedule B:(Technical and Operational Description)
                                                        FOR OFFICIAL USE ONLY



Location of Earth Station Site

E1: Site Identifier: VSAT                 E5. Call Sign:
                     Transportable
E2: Contact Name Linda Cicco              E6. Phone          703 755−6733
                                          Number:
E3. Street:                               E7. City:
                                          E8. County:
E4. State                                 E9. Zip Code

E10. Area of Operation:                   U.S. CONUS, Hawaii and Alaska
E11. Latitude:       0 °0 ’0.0 "
E12. Longitude:      0 °0 ’0.0 "
E13. Lat/Lon Coordinates are:                NAD−27             NAD−83              N/A


E14. Site Elevation (AMSL):               0.0 meters




18


E15. If the proposed antenna(s) operate in the Fixed Satellite Service (FSS) with geostationary satellites, do(es) the
proposed antenna(s) comply with the antenna gain patterns specified in Section 25.209(a) and (b) as demonstrated         Yes   No        N/A
by the manufacturer’s qualification measurement? If NO, provide as a technical analysis showing compliance with
two−degree spacing policy.


E16. If the proposed antenna(s) do not operate in the Fixed Satellite Service (FSS), or if they operate in the Fixed
Satellite Service (FSS) with non−geostationary satellites, do(es) the proposed antenna(s) comply with the antenna        Yes   No        N/A
gain patterns specified in Section 25.209(a2) and (b) as demonstrated by the manufacturer’s qualification
measurements?


E17. Is the facility operated by remote control? If YES, provide the location and telephone number of the control
point.                                                                                                                   Yes        No




E18. Is frequency coordination required? If YES, attach a frequency coordination report as
                                                                                                                         Yes        No


E19. Is coordination with another country required? If YES, attach the name of the country(ies) and plot of
coordination contours as                                                                                                 Yes        No


E20. FAA Notification − (See 47 CFR Part 17 and 47 CFR part 25.113(c)) Where FAA notification is required, have
you attached a copy of a completed FCC Form 854 and or the FAA’s study regarding the potential hazard of the             Yes        No
structure to aviation?
FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS
APPLICATION.
 POINTS OF COMMUNICATION
Satellite Name:    PERMITTED LIST | | If you selected OTHER, please enter the following:




19


E21. Common Name:                                                    E22. ITU Name:
E23. Orbit Location:                                                 E24. Country:
     POINTS OF COMMUNICATION (Destination Points)
E25. Site Identifier:
E26. Common Name:                                                    E27. Country:
 ANTENNA
Site ID                 E28. Antenna Id    E29. Quantity    E30.              E31. Model         E32. Antenna      E41/42. Antenna
                                                            Manufacturer                         Size<meters>      GainTransmint
                                                                                                                   and/or Recieve
                                                                                                                   (____dBi at
                                                                                                                   _____GHz)
VSAT                    1.2M trans         100              AVL               1248K−09           1.2               41.6 dBi at 11.95
Transportable
                                                                                                                   43.1 dBi at 14.25



E28. Antenna       E33/34.           E35. Above       E36. Above Sea E37. Building    E38. Total       E39.             E40. Total
Id                 Diameter          Ground           Level<BR>      Height Above     Input Power at   Maximum          EIRP for al
                   Minor/Major       Level<BR>        (meters)       Ground           antenna          Antenna Height   carriers<BR>
                   (meters)          (meters)                        Level<BR>        flange<BR>       Above            (dBW)
                                                                     (meters)         (Watts)          Rooftop<BR>
                                                                                                       (meters)
1.2M trans         0.0/0.0           1.2              1.2            0.0              4.0              0.0              49.12
FREQUENCY
E28. Antenna Id         E43/44.         E45. T/R Mode       E46. Antenna      E47. Emission      E48. Maximum     E49. Maximum
                        Frequency Bands                     Polarization(H,V, Designator         EIRP per Carrier ERIP Density per
                        (MHz)                               L,R)                                 (dBW)            Carrier
                                                                                                                  (dBW/4kHz)



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1.2M trans         11700             R                     Linear and Circular 930KG7D                 0.0                   0.0
                   12200
E50. Modulation and Services    (If the complete description does not appear in this box, please go to the end of the form to view it in its
entirety.)
     Digital Data Carrier




1.2M trans         14000             T                     Linear and Circular 930KG7D                 48.0                  24.3
                   14500
E50. Modulation and Services    (If the complete description does not appear in this box, please go to the end of the form to view it in its
entirety.)
     Digital Data Carrier




FREQUENCY COORDINATION
E28.           E51. Satellite E52/53.     E54/55.            E56. Earth       E57.             E58. Earth       E59.                E60.
Antenna Id     Orbit Type     Frequency   Range of           Station          Antenna          Station          Antenna             Maximum
                              Limits(MHz) Satellite Arc      Azimuth          Elevation        Azimuth          Elevation           EIRP Density
                                          E/W Limit          Angle            Angle            Angle            Angle               toward the
                                                             Eastern Limit    Eastern Limit    Western          Western             Horizon
                                                                                               Limit            Limit               (dBW/4kHz)


1.2M trans     Geostationary 11700          0.0/ 0.0         0.0              5.0              0.0              5.0                 0.0
                             12200




21


                  Geostationary 14000             0.0/ 0.0         0.0           5.0              0.0             5.0              −18.8
                                14500
REMOTE CONTROL POINT LOCATION
   E61. Call Sign                                                           E65. Phone Number
   E990541                                                                  540 477−5520
   NOTE: Please enter the callsign of the controlling station, not the
callsign for which this application is being filed.
     E62. Street Address
     1305 Industrial Park Rd


     E63. City                                       E67. County                                     E64/68.                  E66. Zip Code
     Mt Jackson                                      Shenandoah                                   State/Country               22842
                                                                                                     VA/ USA


FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT

The public reporting for this collection of information is estimated to average 0.25 − 24 hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the required data, and completing and reviewing the collection of
information. If you have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you,
please write to the Federal Communications Commission, AMD−PERM, Paperwork Reduction Project (3060−0678), Washington, DC 20554.
We will also accept your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to
PRA@fcc.gov. PLEASE DO NOT SEND COMPLETED FORMS TO THIS ADDRESS.

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.




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Document Created: 2019-04-13 12:37:35
Document Modified: 2019-04-13 12:37:35

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