Application Form

This document pretains to SES-STA-20090202-00121 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:

Gold Coast Broadcasting LLC 310-451-4430
310-451-1423
715 Broadway, Suite 320
Santa Monica CA
USA 90401 -
Alvin Souder

Alvin Souder 310-451-4430
Gold Coast Broadcasting, LLC 310-451-1423
715 Broadway E-Mail: [email protected]
Suite 320
Santa Monica CA
USA 90401 -
Alvin Souder Other
(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 SESLIC2009011600048 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
02/06/2009
7. CityVentura 8. Latitude
(dd mm ss.s h) 34 14 17.0 N
9. State CA 10. Longitude
(dd mm ss.s h) 119 12 8.0 W
11. Please supply any need attachments.
Attachment 1: STA-Letter Attachment 2: Attachment 3:
12. Description. Gold Coast Broadcasting is requesting a 60 day STA to start satellite operations while their permanent FSS Ku-band application (SES-LIC-20090116-00048/E090008)is currently pending on Public Notice with the Commission. Additional information about 60 day STA request is in attached letter.
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
Alvin Souder 		15. Title of Person Signing
Vice President of Managing Member
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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