Application Form [pdf]

This document pretains to SES-STA-20101006-01262 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2010100601262_844012

                                                                                                         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:
KA288 STA Request to communicate with SES−3 at 77.25 W.L.
    1. Applicant

              Name:        SES Americom, Inc.        Phone Number:                  202−478−7137
              DBA Name:                              Fax Number:                    202−478−7101
              Street:      2001 L Street, NW         E−Mail:                        daniel.mah@ses.com
                           Suite 800
              City:        Washington                State:                         DC
              Country:     USA                       Zipcode:                       20036       −
              Attention:   Daniel C. H. Mah




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    2. Contact

                 Name:         Karis A. Hastings, Esq.               Phone Number:                       202−637−5767
                 Company:      Hogan Lovells US LLP                  Fax Number:                         202−637−5910
                 Street:       555 Thirteenth Street, NW             E−Mail:                             karis.hastings@hoganlovells.com



                 City:         Washington                            State:                              DC
                 Country:      USA                                   Zipcode:                            20004      −1120
                 Attention:                                          Relationship:


    (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 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




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    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: Request for STA                     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.)
        SES Americom, Inc. seeks special temporary authority for operation of earth station KA288
        in connection with the in−orbit testing and TT&C of the SES−3 space station at 77.25 WL.




    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
      Daniel C. H. Mah                                                           Regulatory 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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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: 2019-05-08 11:42:58
Document Modified: 2019-05-08 11:42:58

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