Application Form [pdf]

This document pretains to SES-STA-20041102-01617 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2004110201617_401829

                                                                                                          Approved by OMB
                                                                                                                 3060−0678

                               APPLICATION FOR EARTH STATION SPECIAL TEMPORARY AUTHORITY



APPLICANT INFORMATIONEnter a description of this application to identify it on the main menu:
E7670 STA
    1. Applicant

              Name:        Ascent Media Systems and       Phone Number:             321−952−4205
                           Technology Services, LLC
              DBA Name:                                   Fax Number:               321−952−4235
              Street:      2330 Commerce Park Drive, NE   E−Mail:                   goehler@ascentmedia.com
                           Suite 1
              City:        Palm Bay                       State:                    FL
              Country:     USA                            Zipcode:                  32905       −7721
              Attention:   Ms Virginia A Oehler




1


    2. Contact

                 Name:        Ms. Virginia A Oehler               Phone Number:                         321−952−4205
                 Company:     Ascent Media Systems and            Fax Number:                           321−952−4235
                              Technology Services, LLC
                 Street:      2330 Commerce Park Drive, NE        E−Mail:                               goehler@ascentmedia.com
                              Suite 1
                 City:        Palm Bay                            State:                                FL
                 Country:     USA                                 Zipcode:                              32905       −7721
                 Contact                                          Relationship:
                 Title:


    3. Reference File Number SESMOD1999031500374
    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. CityDuluth                                                            8. Latitude
                                                                             (dd mm ss.s h)   46   47    4.0    N


2


    9. State   MN                                                              10. Longitude
                                                                               (dd mm ss.s h)     92   6    16.0   W
    11. Please supply any need attachments.
    Attachment 1: E7670 STA                           Attachment 2:                                        Attachment 3:


    12. Description.   (If the complete description does not appear in this box, please go to the end of the form to view it in its entirety.)
        The failure to file these license renewal applications resulted from the prolonged absence
        of the Ascent Media regulatory compliance employee due to illness. Upon the discovery of
        these lapsed licenses, applications for special temporary authority to operate the earth
        stations were prepared and filed as expeditiously as possible.



    13. By checking Yes, the undersigned certifies that neither applicant nor any other party to the application is               Yes            No
    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.


    14. Name of Person Signing                                                 15. Title of Person Signing
      Robert M. Lawson                                                           Vice President & General 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).




3


FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT

The public reporting for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the required data, and completing and reviewing the collection of information. If you
have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you, please write to the
Federal Communications Commission, AMD−PERM, Paperwork Reduction Project (3060−0678), Washington, DC 20554. We will also accept
your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to jboley@fcc.gov. PLEASE
DO NOT SEND COMPLETED FORMS TO THIS ADDRESS.

Remember − You are not required to respond to a collection of information sponsored by the Federal government, and the government may not
conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This
collection has been assigned an OMB control number of 3060−0678.

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.




4



Document Created: 2019-04-12 23:58:06
Document Modified: 2019-04-12 23:58:06

© 2024 FCC.report
This site is not affiliated with or endorsed by the FCC