Application Form

This document pretains to SES-STA-20041209-01811 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:

Wyoming Channel 2, Inc. 501-219-2400 x240
501-221-1101
#1 Shackleford Drive [email protected]
Suite 400
Little Rock AR
USA 72211 -
Mrs Lori E Withrow

Jason Roberts 5012192400
Wyoming Channel 2, Inc. 501-221-1101
#1 Shackleford Drive E-Mail: [email protected]
Suite 400
Little Rock AR
USA 72211 -
Corporate Counsel Legal Counsel
3. Reference File Number SESMOD2004113001756
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
12/25/2004
7. CityCasper 8. Latitude
(dd mm ss.s h)
42 51 20.0 N
9. State WY 10. Longitude
(dd mm ss.s h)
106 21 15.0 W
11. Please supply any need attachments.
Attachment 1: Attachment 2: Attachment 3:
12. Description. Wyoming Channel 2, Inc. intends to use the facilities specified in the above referenced application to provide digital and analog broadcast signals and associated data delivery systems. Wyoming Channel 2, Inc. has lost use of the current authorized site, necessitating the need for the above-referenced modification. Because of this site loss, and to avoid a loss of service, thereby harming the public interest, this request for an STA is respectfully requested.
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
Lori M. Withrow
15. Title of Person Signing
Corporate Secretary
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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