Application Form [pdf]

This document pretains to SES-STA-20041214-01837 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2004121401837_409818

                                                                                                             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:
Intelsat − STA to Test Collocated C−Band Antennas in Hagerstown, MD
    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 H. Crandall




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    2. Contact

                 Name:         Carl R. Frank                      Phone Number:                         202−719−7269
                 Company:      Wiley Rein & Fielding LLP          Fax Number:                           202−719−7049
                 Street:       1776 K Street, NW                  E−Mail:                               cfrank@wrf.com


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


    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
          12/20/2004
    7. CityHagerstown                                                        8. Latitude
                                                                             (dd mm ss.s h)   39   35    0.4    N




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    9. State   MD                                                              10. Longitude
                                                                               (dd mm ss.s h)     77   45    30.7   W
    11. Please supply any need attachments.
    Attachment 1: Exhibit A                           Attachment 2: Exhibit B                            Attachment 3: Exhibit C


    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.)
        Intelsat LLC seeks special temporary authorization from December 20, 2004 to December 30,
        2004 to perform antenna testing of two collocated C−band transmit/receive earth stations
        at its Hagerstown, MD facility. The tests will use limited frequencies for which
        coordination has been completed. Applications for these antennas will be submitted soon



    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
      Patrick J. Cerra                                                           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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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.




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12. Description

Intelsat LLC seeks special temporary authorization from December 20, 2004 to December 30, 2004 to
perform antenna testing of two collocated C−band transmit/receive earth stations at its
Hagerstown, MD facility. The tests will use limited frequencies for which coordination has been
completed. Applications for these antennas will be submitted soon after completing the
coordination of the rest of the frequency bands.




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Document Created: 2019-05-08 21:33:22
Document Modified: 2019-05-08 21:33:22

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