Application Form [pdf]

This document pretains to SES-STA-20071120-01605 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2007112001605_606516

                                                                                                           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:
STA to test earth station prior to deployment in Gulf of Mexico
    1. Applicant

              Name:        PetroCom License Corporation   Phone Number:             504−736−9400
              DBA Name:                                   Fax Number:               504−734−6100
              Street:      5901 Earhart Expressway        E−Mail:                   kwright@petrocom.com


              City:        Harahan                        State:                    LA
              Country:     USA                            Zipcode:                  70123       −
              Attention:   Mr Kenneth Wright




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    2. Contact

                 Name:         Russell Fox                         Phone Number:                        202.434.7483
                 Company:      Mintz, Levi, Cohn, Ferris, Glovsky Fax Number:                           202.434.7400
                               and Popeo, P.C.
                 Street:       701 Pennsylvania Ave., NW           E−Mail:                              rfox@mintz.com
                               Suite 900
                 City:         Washington                          State:                                DC
                 Country:      USA                                 Zipcode:                             20004      −
                 Attention:    Russell Fox                         Relationship:                         Legal Counsel


    (If your application is related to an application filed with the Commission, enter either the file number or the IB Submission ID of the related
    application. Please enter only one.)
     3. Reference File Number SESLIC2007062200852 or Submission ID
    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
          11/23/2007




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    7. CityIngleside                                                           8. Latitude
                                                                               (dd mm ss.s h)     27   52    5.0    N
    9. State   TX                                                              10. Longitude
                                                                               (dd mm ss.s h)     97   10    24.0   W
    11. Please supply any need attachments.
    Attachment 1:                                     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.)
        STA for testing antenna onshore prior to deployment in the Gulf of Mexico.




    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
      Jon Denton                                                                 Engineering 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).




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THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104−13, OCTOBER
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Document Created: 2019-04-23 00:11:52
Document Modified: 2019-04-23 00:11:52

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