Application Form SES-STA-20040917-01390

Application Form

This document pretains to SES-STA-20040917-01390 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 for KA258 to Provide IOT for IA-8 Launch

1. Applicant

Name:	Intelsat LLC	Phone Number:	202-944-7848
DBA Name:		Fax Number:	202-944-7860
Street:	3400 International Drive, N.W.	E-Mail:	susan.crandall@intelsat.com

City:	Washington	State:	DC
Country:	USA	Zipcode:	20008 -3006
Attention:	Susan Crandall

2. Contact

Name:	Jennifer Hindin	Phone Number:	202-719-4975
Company:	Wiley Rein & Fielding LLP	Fax Number:	202-719-7049
Street:	1776 K Street, N.W.	E-Mail:	jhindin@wrf.com

City:	Washington	State:	DC
Country:	USA	Zipcode:	20006 -
Contact Title:		Relationship:	Legal Counsel

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

7. CityClarksburg

8. Latitude
(dd mm ss.s h) 39 13 6.6 N

9. State MD

10. Longitude
(dd mm ss.s h) 77 16 15.3 W

11. Please supply any need attachments.

Attachment 1: Exhibit A

Attachment 2: Exhibit B

Attachment 3:

12. Description. Intelsat LLC herein requests a grant of Special Temporary Authority from November 22, 2004 through January 21, 2005 to use the KA258 earth station to provide in-orbit testing (IOT) in support of the IA-8 satellite currently scheduled for launch in mid-November 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
Patrick J. Cerra

15. Title of Person Signing
Vice 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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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.