Application Form

This document pretains to SES-STA-20031009-01395 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:

Locked Stream LLC 310-823-4171
310-305-8274
24 Topsail Street [email protected]
#2
Marina del Rey CA
USA 90292 -
Mr Simon G Talbot

Brad Youngblood (972) 422-7200
Micronet Communications, Inc. (972) 422-1900
720 F Ave E-Mail: [email protected]
Suite 100
Plano TX
USA 75074 -
Systems Engineer Engineer
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 CGX - Fixed Satellite Transmit/Receive Earth Station
5. Type Request
Use Prior to Grant Change Station Location Other
6. Requested Use Prior Date
10/15/2003
7. City 8. Latitude
(dd mm ss.s h)
0 0 0.0 N
9. State 10. Longitude
(dd mm ss.s h)
0 0 0.0 W
11. Please supply any need attachments.
Attachment 1: Justificat Attachment 2: Attachment 3:
12. Description. IB2003001977
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
Simon Talbot
15. Title of Person Signing
Engineer
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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