Application Form

This document pretains to SES-STA-20031208-01780 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:

Capital Communications Company Inc 515-457-9645
515-457-1034
3909 WESTOWN PARKWAY
ATT. DENNIS POFFENBURGER
WEST DES MOINES IA
USA 50266 -
DENNIS POFFENBURGER

Arthur Landerholm 202-637-2200
Latham & Watkins LLP 202-637-2201
555 ELEVENTH ST., NW E-Mail: [email protected]
Suite 1000
Washington DC
USA 20004 -1304
ATTORNEY Legal Counsel
3. Reference File Number SESLIC2003110401550
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
11/20/2003
7. CityAmes 8. Latitude
(dd mm ss.s h)
0 0 0.0
9. State IA 10. Longitude
(dd mm ss.s h)
0 0 0.0
11. Please supply any need attachments.
Attachment 1: Sup. Info. Attachment 2: ES App. Attachment 3:
12. Description. Please see Attachment 1 for more information.
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
Phillip J. Lombardo
15. Title of Person Signing
President
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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