Application Form

This document pretains to SES-STA-20050718-00932 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:

GE Healthcare 202-637-4535
202-637-4530
1299 Pennsylvania Ave, NW [email protected]
Washington DC
USA 20004 -
F William LeBeau

F. William LeBeau 202-637-4535
GE Healthcare 202-637-4530
1299 Pennsylvania Avenue, NW E-Mail: [email protected]
Washington DC
USA 20004 -
3. Reference File Number SESLIC2005062400812
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
06/24/2005
7. CityWaukesha 8. Latitude
(dd mm ss.s h)
43 3 10.0 N
9. State WI 10. Longitude
(dd mm ss.s h)
88 11 41.0 W
11. Please supply any need attachments.
Attachment 1: Attachment 2: Attachment 3:
12. Description. GE Healthcare (the 'Applicant') seeks an extension of emergency special temporary authority to operate the proposed earth station in order to ensure delivery of critical health care services. GE Healthcare has been delivering the 'Patient Channel' and the Training in Partnership TV ('TIP TV') to hospitals throughout the country via satellite earth station facilities authorized to outside vendors. The Patient Channel is a critical educational and informational service used by patients recovering from a variety of injuries. TIP TV is a continuing educational and informational service for medical diagnostic personnel.
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
Dee Mellor
15. Title of Person Signing
Vice President, Global Services
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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