Application Form SES-STA-20040730-01084

Application Form

This document pretains to SES-STA-20040730-01084 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:

STA Request for Flushing, NY Tennis Tournament - Ku- Band

1. Applicant

Name:	BT Americas Inc.	Phone Number:	703-755-6733
DBA Name:		Fax Number:	703-755-6740
Street:	11440 Commerce Park Drive	E-Mail:	[email protected]
	Suite 5041
City:	Reston	State:	VA
Country:	USA	Zipcode:	20191 -
Attention:	Ms Linda J Cicco

2. Contact

Name:	Linda J. Cicco	Phone Number:	703 755 6733
Company:	BT Americas Inc.	Fax Number:	703 755- 6740
Street:	11440 Commerce Park Drive	E-Mail:	[email protected]
	Suite 5041
City:	Reston	State:	VA
Country:	USA	Zipcode:	20191 -
Contact Title:	Regulatory Compliance Manager	Relationship:	Other

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 CGV - Fixed Satellite VSAT System

5. Type Request

Use Prior to Grant

Change Station Location

Other

6. Requested Use Prior Date
08/15/2004

7. CityFlushing

8. Latitude
(dd mm ss.s h) 40 45 0.3 N

9. State NY

10. Longitude
(dd mm ss.s h) 73 51 6.2 W

11. Please supply any need attachments.

Attachment 1: 312 Schedule B

Attachment 2: Rad Haz Study

Attachment 3:

12. Description. STA request for operation of 2 1.5 meter Ku-Band temporary fixed antennae to cover the USTA tennis tournament in Flushing, NY August 15 thru September 15, 2004.

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

14. Name of Person Signing
Linda J. Cicco

15. Title of Person Signing
Reg. Compliance Manager

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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THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104-13, OCTOBER 1, 1995, 44 U.S.C. SECTION 3507.