Application Form [pdf]

This document pretains to SES-STA-20110623-00733 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2011062300733_898620

                                                                                                            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:
Request for Further 30−day STA Extension to use E070181 to perform on−station TT&C for NSS−703 at 47.05W.
    1. Applicant

              Name:        SES Americom, Inc.        Phone Number:                 202−478−7137
              DBA Name:                              Fax Number:                   202−478−7101
              Street:      1129 20th Street NW       E−Mail:                       daniel.mah@ses.com
                           Suite 1000
              City:        Washington                State:                         DC
              Country:     USA                       Zipcode:                      20036       −
              Attention:   Daniel C.H. Mah




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    2. Contact

                 Name:         Daniel C.H. Mah                     Phone Number:                          202−478−7137
                 Company:      SES Americom, Inc.                  Fax Number:                            202−478−7101
                 Street:       1129 20th Street NW                 E−Mail:                                daniel.mah@ses.com


                 City:         Washington                          State:                                 DC
                 Country:      USA                                 Zipcode:                               20036       −
                 Attention:    Daniel C.H. Mah                     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 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


    7. CityMount Airy                                                         8. Latitude
                                                                              (dd mm ss.s h)    39   22    35.9   N


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    9. State   MD                                                              10. Longitude
                                                                               (dd mm ss.s h)     77   4    48.3   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.)
        Request for a further 30−day extension of STA to use E070181 to perform on−station TT&C
        for NSS−703 at 47.05W, pending grant of Permitted List petition. See File No. SES−STA−
        20110218−00182 (granted 3/3/2011), SES−STA−20110309−00283 (granted 3/29/2011), SES−STA−
        20110408−00415 (granted 4/29/2011) SES−STA−20110519−00601 (granted 5/26/2011). Related



    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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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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12. Description

Request for a further 30−day extension of STA to use E070181 to perform on−station TT&C for NSS−
703 at 47.05W, pending grant of Permitted List petition. See File No. SES−STA−20110218−00182
(granted 3/3/2011), SES−STA−20110309−00283 (granted 3/29/2011), SES−STA−20110408−00415 (granted
4/29/2011) SES−STA−20110519−00601 (granted 5/26/2011). Related Permitted List petition




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Document Created: 2019-04-23 23:38:20
Document Modified: 2019-04-23 23:38:20

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