Application Form [pdf]

This document pretains to SES-STA-20080529-00686 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2008052900686_643740

                                                                                                           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:
E000156 STA Application
    1. Applicant

              Name:        Honeywell International   Phone Number:                  602−436−7673
              DBA Name:                              Fax Number:                    602−436−4040
              Street:      21111 N. 19th Ave         E−Mail:                        carl.shore@honeywell.com


              City:        Phoenix                   State:                         AZ
              Country:     USA                       Zipcode:                       85027       −
              Attention:   Carl Shore




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    2. Contact

                 Name:         Donna Balaguer                      Phone Number:                        (202) 626−7719
                 Company:      Fish & Richardson PC                Fax Number:                          (202) 783−2331
                 Street:       1425 K Street NW                    E−Mail:                              balaguer@fr.com
                               11th Floor
                 City:         Washington                          State:                                DC
                 Country:      USA                                 Zipcode:                             20005         −
                 Attention:    Donna Balaguer                      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 SESLIC2000040300534 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    CGB − Mobile Satellite Earth Stations
    5. Type Request

        Use Prior to Grant                                Change Station Location                             Other


    6. Requested Use Prior Date
          05/23/2008
    7. City                                                                   8. Latitude
                                                                              (dd mm ss.s h)    0   0   0.0


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    9. State                                                                   10. Longitude
                                                                               (dd mm ss.s h)     0   0   0.0
    11. Please supply any need attachments.
    Attachment 1: STA & Waiver Request                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.)
        See Attachment 1.




    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
      Carl L. Shore                                                              Sr. Technical Manager/Honeywell Satcom Systems
               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 public reporting for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions,
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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
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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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Document Created: 2019-04-23 12:18:17
Document Modified: 2019-04-23 12:18:17

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