Application Form

This document pretains to SES-MOD-INTR2021-02411 for Modification on a Satellite Earth Station filing.

REMOTE CONTROL POINT LOCATION
E61. Call Sign

NOTE: Please enter the callsign of the controlling station, not the callsign for which this application is being filed. 		E66. Phone Number
E62. Street Address
E63. City
 E68. County
 E67/68. State/Country
/ 		E64. Zip Code

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: AMNES E5. Call Sign:
E2: Contact Name Greg Tooke E6. Phone Number: (907) 550−8364
E3. Street: Auntie Mary Nicoli Elementary School E7. City: Aniak
E8. County: Bethel Census Area
E4. State AK E9. Zip Code 99557
E10. Area of Operation: Aniak, AK
E11. Latitude: 61 ° 34 ' 49.0 " N
E12. Longitude: 159 ° 31 ' 51.1 " W
E13. Lat/Lon Coordinates are: NAD-27 NAD-83 N/A
E14. Site Elevation (AMSL): 11.34 meters
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 by the manufacturer's qualification measurement? If NO, provide as a technical analysis showing compliance with two-degree spacing policy.
Yes No N/A
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 gain patterns specified in Section 25.209(a2) and (b) as demonstrated by the manufacturer's qualification measurements?
Yes No N/A
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 structure to aviation?
FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS APPLICATION.
Yes No
POINTS OF COMMUNICATION
Satellite Name:AMC-6 (S2347) | AMC-6 | 139.0 W.L. If you selected OTHER, please enter the following:
E21. Common Name: E22. ITU Name:
E23. Orbit Location: E24. Country:
Satellite Name:GALAXY 30 (S3016) | | 125 W.L. If you selected OTHER, please enter the following:
E21. Common Name: E22. ITU Name:
E23. Orbit Location: E24. Country:
Satellite Name:EUTELSAT115WB(S2938) | EUTELSAT 115 WB | 114.9 W.L. If you selected OTHER, please enter the following:
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
dBi at
/
FREQUENCY
E50. Modulation and Services
FREQUENCY COORDINATION
/
REMOTE CONTROL POINT LOCATION
E61. Call Sign

NOTE: Please enter the callsign of the controlling station, not the callsign for which this application is being filed. 		E66. Phone Number
E62. Street Address
E63. City
 E68. County
 E67/68. State/Country
/ 		E64. Zip Code

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: E5. Call Sign:
E2: Contact Name E6. Phone Number:
E3. Street: E7. City:
E8. County:
E4. State E9. Zip Code
E10. Area of Operation:
E11. Latitude: ° ' "
E12. Longitude: ° ' "
E13. Lat/Lon Coordinates are: NAD-27 NAD-83 N/A
E14. Site Elevation (AMSL): meters
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 by the manufacturer's qualification measurement? If NO, provide as a technical analysis showing compliance with two-degree spacing policy.
Yes No N/A
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 gain patterns specified in Section 25.209(a2) and (b) as demonstrated by the manufacturer's qualification measurements?
Yes No N/A
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 structure to aviation?
FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS APPLICATION.
Yes No
POINTS OF COMMUNICATION
Satellite Name: If you selected OTHER, please enter the following:
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
dBi at
/
FREQUENCY
E50. Modulation and Services
FREQUENCY COORDINATION
/
REMOTE CONTROL POINT LOCATION
E61. Call Sign

NOTE: Please enter the callsign of the controlling station, not the callsign for which this application is being filed. 		E66. Phone Number
E62. Street Address
E63. City
 E68. County
 E67/68. State/Country
/ 		E64. Zip Code

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: E5. Call Sign:
E2: Contact Name E6. Phone Number:
E3. Street: E7. City:
E8. County:
E4. State E9. Zip Code
E10. Area of Operation:
E11. Latitude: ° ' "
E12. Longitude: ° ' "
E13. Lat/Lon Coordinates are: NAD-27 NAD-83 N/A
E14. Site Elevation (AMSL): meters
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 by the manufacturer's qualification measurement? If NO, provide as a technical analysis showing compliance with two-degree spacing policy.
Yes No N/A
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 gain patterns specified in Section 25.209(a2) and (b) as demonstrated by the manufacturer's qualification measurements?
Yes No N/A
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 structure to aviation?
FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS APPLICATION.
Yes No
POINTS OF COMMUNICATION
Satellite Name: If you selected OTHER, please enter the following:
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
dBi at
/
FREQUENCY
E50. Modulation and Services
FREQUENCY COORDINATION
/
REMOTE CONTROL POINT LOCATION
E61. Call Sign

NOTE: Please enter the callsign of the controlling station, not the callsign for which this application is being filed. 		E66. Phone Number
E62. Street Address
E63. City
 E68. County
 E67/68. State/Country
/ 		E64. Zip Code

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: E5. Call Sign:
E2: Contact Name E6. Phone Number:
E3. Street: E7. City:
E8. County:
E4. State E9. Zip Code
E10. Area of Operation:
E11. Latitude: ° ' "
E12. Longitude: ° ' "
E13. Lat/Lon Coordinates are: NAD-27 NAD-83 N/A
E14. Site Elevation (AMSL): meters
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 by the manufacturer's qualification measurement? If NO, provide as a technical analysis showing compliance with two-degree spacing policy.
Yes No N/A
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 gain patterns specified in Section 25.209(a2) and (b) as demonstrated by the manufacturer's qualification measurements?
Yes No N/A
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 structure to aviation?
FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS APPLICATION.
Yes No
POINTS OF COMMUNICATION
Satellite Name: If you selected OTHER, please enter the following:
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
dBi at
/
FREQUENCY
E50. Modulation and Services
FREQUENCY COORDINATION
/
REMOTE CONTROL POINT LOCATION
E61. Call Sign

NOTE: Please enter the callsign of the controlling station, not the callsign for which this application is being filed. 		E66. Phone Number
E62. Street Address
E63. City
 E68. County
 E67/68. State/Country
/ 		E64. Zip Code

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: E5. Call Sign:
E2: Contact Name E6. Phone Number:
E3. Street: E7. City:
E8. County:
E4. State E9. Zip Code
E10. Area of Operation:
E11. Latitude: ° ' "
E12. Longitude: ° ' "
E13. Lat/Lon Coordinates are: NAD-27 NAD-83 N/A
E14. Site Elevation (AMSL): meters
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 by the manufacturer's qualification measurement? If NO, provide as a technical analysis showing compliance with two-degree spacing policy.
Yes No N/A
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 gain patterns specified in Section 25.209(a2) and (b) as demonstrated by the manufacturer's qualification measurements?
Yes No N/A
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 structure to aviation?
FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS APPLICATION.
Yes No
POINTS OF COMMUNICATION
Satellite Name: If you selected OTHER, please enter the following:
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
dBi at
/
FREQUENCY
E50. Modulation and Services
FREQUENCY COORDINATION
/
REMOTE CONTROL POINT LOCATION
E61. Call Sign

NOTE: Please enter the callsign of the controlling station, not the callsign for which this application is being filed. 		E66. Phone Number
E62. Street Address
E63. City
 E68. County
 E67/68. State/Country
/ 		E64. Zip Code


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