Application Form

This document pretains to SES-STA-20091027-01369 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:

KVH Industries, Inc. 401-845-8148
401-845-8116
50 Enterprise Center [email protected]
Middletown RI
USA 02842 -
Ms Felise Feingold

Carlos Nalda 202-626-6659
Squire, Sanders & Dempsey L.L.P.
1201 Pennsylvania Avenue, NW E-Mail: [email protected]
Suite 500
Washington DC
USA 20004 -
Mr. Carlos Nalda 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
SESSTA2009083101093 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
11/04/2009
7. City 8. Latitude
(dd mm ss.s h)
0 0 0.0
9. State 10. Longitude
(dd mm ss.s h)
0 0 0.0
11. Please supply any need attachments.
Attachment 1: Narrative Statement Attachment 2: Attachment 3:
12. Description. KVH requests a 60-day extension of the Special Temporary Authority granted under Call Sign E090001, File No. SES-STA-20090831-01093, to permit the continued operations of up to 600 earth stations on vessels via the gateway earth station located in Kapolei, HI (Call Sign E010236).
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
Felise Feingold
15. Title of Person Signing
Vice President and Geneal Counsel
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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