Application Form

This document pretains to SES-STA-20120119-00079 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:

Sirius XM Radio Inc. 202−380−1383
202−380−4981
1221 Avenue of the Americas [email protected]
36th Floor
New York NY
USA 10020 -
James S. Blitz

Jennifer D. Hindin 202-719-4975
Wiley Rein LLP 202-719-7049
1776 K Street, NW E-Mail: [email protected]
Washington DC
USA 20006 -2398
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. CityEllenwood 8. Latitude
(dd mm ss.s h)
33 39 51.0 N
9. State GA 10. Longitude
(dd mm ss.s h)
84 16 24.0 W
11. Please supply any need attachments.
Attachment 1: FrequencyCoordinatio Attachment 2: Narrative Attachment 3:
12. Description. Sirius XM Radio Inc. requests special temporary authority to use its Ellenwood, Georgia earth station with call sign E080168 to provide launch and early orbit phase services to, and in orbit testing of, the FM-6 satellite.
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
James S. Blitz
15. Title of Person Signing
V.P., 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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