Application Form

This document pretains to SES-STA-20030702-00921 for Special Temporal Authority on a Satellite Earth Station filing.

Approved by OMB
3060-0678
APPLICATION FOR EARTH STATION SPECIAL TEMPORARY AUTHORITY


APPLICANT INFORMATION

Enter a description of this application to identify it on the main menu:

Television del Pacifico Teledos S. A. 305-468-1645
305-468-8509
Av. Eloy Alfaro 5400 y Rio Coca [email protected]
Quito
-
Mr Cesar Macias

Edward A. Maldonado, Esq. 305-468-1645
The Law Office of Edward A. Maldonado, P.A. 305-468-8509
8181 NW 36 St. E-Mail: [email protected]
Suite 4
Miami FL
USA 33166 -
Regulatory Attorney Same
3. Reference File Number
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 CGS - Fixed Satellite Small Transmit/Receive Earth Station
5. Type Request
Use Prior to Grant Change Station Location Other
6. Requested Use Prior Date
07/04/2003
7. CityHouston 8. Latitude
(dd mm ss.s h)
29 43 17.0 N
9. State TX 10. Longitude
(dd mm ss.s h)
95 20 54.0 W
11. Please supply any need attachments.
Attachment 1: STA Letter Attachment 2: Rad Haz Attachment 3:
12. Description. Special Temporary Authority is required to transmit Ecuadorean National Soccer team news & interviews to the Ecuadorean TV station for the benefit of the Ecuadorean public.
13. 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
14. Name of Person Signing
Ing. Cesar Macias
15. Title of Person Signing
Technical VP
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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