Application Form

This document pretains to SES-STA-20120822-00778 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:

Science Applications International Corporation 571-319-8616
6909 Metro Park Dr [email protected]
Alexandria VA
USA 22310 -
Mr Ronald L Richards

Science Applications International Corporation 571-319-8616
6909 Metro Park Dr E-Mail: [email protected]
Alexandria VA
USA 22310 -
(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
09/08/2012
7. CityGuam-Anderson AFB 8. Latitude
(dd mm ss.s h) 13 35 16.2 N
9. State GU 10. Longitude
(dd mm ss.s h) 144 55 9.0 E
11. Please supply any need attachments.
Attachment 1: Attachment A Attachment 2: Attachment B Attachment 3: Attachment C
12. Description. The Special Temporary Authority (STA) is requested to enable temporary use of a satellite earth station operated by Science Applications International Corporation (SAIC) for the National Geospatial-Intelligence Agency (NGA) to participate in a critical US Pacific Command (PACOM) Exercise/Demonstration to be held in the 8 September through 25 September 2012 timeframe.
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
Ronald L. Richards 		15. Title of Person Signing
Principal Engineer
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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