Application Form [pdf]

This document pretains to SES-STA-20160707-00633 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2016070700633_1142667

                                                                                                             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 30−Day STA Using Fillmore, CA Earth Station E4132 for Sirius FM−2 Satellite
    1. Applicant

              Name:        Intelsat License LLC       Phone Number:                 703−559−7848
              DBA Name:                               Fax Number:                   703−559−8539
              Street:      c/o Intelsat Corporation   E−Mail:                       susan.crandall@intelsat.com
                           7900 Tysons One Place
              City:        McLean                     State:                        VA
              Country:     USA                        Zipcode:                      22102        −5972
              Attention:   Susan H. Crandall




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    2. Contact

                 Name:         Cynthia J. Grady                    Phone Number:                          703−559−6949
                 Company:      Intelsat Corporation                Fax Number:                            703−559−8539
                 Street:       7900 Tysons One Place               E−Mail:                                cynthia.grady@intelsat.com


                 City:         McLean                              State:                                 VA
                 Country:      USA                                 Zipcode:                               22102       −5972
                 Attention:                                        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. CityFillmore                                                           8. Latitude
                                                                              (dd mm ss.s h)    34   24    22.0   N


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    9. State   CA                                                              10. Longitude
                                                                               (dd mm ss.s h)     118   53   34.0    W
    11. Please supply any need attachments.
    Attachment 1: STA Request                         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.)
        Intelsat License LLC herein requests a grant of Special Temporary Authority for 30 days,
        commencing immediately upon grant, to use its Fillmore, California C−band earth station,
        call sign E4132, to perform de−orbit maneuvers for the non−geostationary Sirius FM−2
        satellite (collectively with Sirius FM−1 and Sirius FM−3, call sign S2105). Sirius FM−2



    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
      Cynthia J. Grady                                                           Regulatory Counsel, Intelsat Corporation
               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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FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT

The public reporting for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the required data, and completing and reviewing the collection of information. If you
have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you, please write to the
Federal Communications Commission, AMD−PERM, Paperwork Reduction Project (3060−0678), Washington, DC 20554. We will also accept
your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to PRA@fcc.gov. PLEASE
DO NOT SEND COMPLETED FORMS TO THIS ADDRESS.

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

Intelsat License LLC herein requests a grant of Special Temporary Authority for 30 days,
commencing immediately upon grant, to use its Fillmore, California C−band earth station, call sign
E4132, to perform de−orbit maneuvers for the non−geostationary Sirius FM−2 satellite (collectively
with Sirius FM−1 and Sirius FM−3, call sign S2105). Sirius FM−2 is currently being de−orbited and
the de−orbit is expected to last approximately 30 days.




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Document Created: 2019-04-12 12:35:59
Document Modified: 2019-04-12 12:35:59

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