Application Form [pdf]

This document pretains to SES-MOD-20131113-01067 for Modification on a Satellite Earth Station filing.

IBFS_SESMOD2013111301067_1020854

Approved by OMB 3060−0678 Date & Time Filed: Nov 10 2013 4:56:59:586PM File Number: SES−MOD−INTR2013−02504 FCC APPLICATION FOR SPACE AND EARTH STATION:MOD OR AMD − MAIN FORM 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: WTAP E7726 1−8. Legal Name of Applicant Name: United Service Source Inc Phone Number: 321−723−5395 x135 DBA Fax Number: 321−727−3107 Name: Street: 9145 Ellis Road E−Mail: michele.tully@ussi.org City: West Melbourne State: FL Country: USA Zipcode: 32904 − Attention: Michele Tully 1


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 CGX − Fixed Satellite Transmit/Receive Earth Station 18. If this filing is in reference to an 19. If this filing is an amendment to a pending application enter both fields, if this filing is a existing station, enter: modification please enter only the file number: (a) Call sign of station: (a) Date pending application was filed: (b) File number: E7726 SESRWL2004110201633 3


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 e. Geostationary Space Station f. Non−Geostationary Space Station g. Other (please specify) 26. TYPE OF EARTH STATION FACILITY: Transmit/Receive Transmit−Only Receive−Only N/A "For Space Station applications, select N/A." 5

PURPOSE OF MODIFICATION 27. The purpose of this proposed modification is to: (Place an ’X’ in the box(es) next to all that apply.) a −− authorization to add new emission designator and related service b −− authorization to change emission designator and related service c −− authorization to increase EIRP and EIRP density d −− authorization to replace antenna e −− authorization to add antenna f −− authorization to relocate fixed station g −− authorization to change frequency(ies) h −− authorization to add frequency i −− authorization to add Points of Communication (satellites & countries) j −− authorization to change Points of Communication (satellites & countries) k −− authorization for facilities for which environmental assessment and radiation hazard reporting is required l −− authorization to change orbit location m −− authorization to perform fleet management n −− authorization to extend milestones o −− Other (Please specify) 6



Document Created: 2019-04-23 13:51:48
Document Modified: 2019-04-23 13:51:48
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