Application Form [pdf]

This document pretains to SES-STA-20130927-00842 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2013092700842_1014114

                                                                                                    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:
STA REQUEST 2.0 METER C−BAND TRANSPORTABLE FIXED EARTH STATION
    1. Applicant

              Name:        TELEVISA, SA de CV        Phone Number:                  2028281860
              DBA Name:                              Fax Number:                    2029555564
              Street:      800 17TH STREET NW, STE   E−Mail:                        NORM.LEVENTHAL@HKLAW.
                           1100                                                     COM


              City:        WASHINGTON                State:
              Country:     USA                       Zipcode:                          −
              Attention:   NORMAN LEVENTHAL ESQ




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    2. Contact

                 Name:         NORMAN LEVENTHAL ESQ                Phone Number:                        2028281860
                 Company:      HOLLAND & KNIGHT                    Fax Number:                          2029555564
                 Street:       800 17TH STREET NW                  E−Mail:                              NORM.LEVENTHAL@HKLAW.
                                                                                                        COM
                               SUITE 1100
                 City:         WASHINGTON                          State:                                DC
                 Country:      USA                                 Zipcode:                             20006      −3906
                 Attention:    NORMAN LEVENTHAL                    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 IB2013002100
    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
          10/01/2013




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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: STA REQUEST                         Attachment 2: PRIOR COORDINATION                    Attachment 3: FCC FORM 312


    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.)
        NULL




    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
      WILLIAM AQUIRRE BALLESTEROS                                                GENERAL SATELLITE DIRECTOR
               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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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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Document Created: 2019-05-30 23:03:48
Document Modified: 2019-05-30 23:03:48

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