Application Form SES-STA-20170811-00905

Application Form

This document pretains to SES-STA-20170811-00905 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:

Blackhawk (E020248) STA to Move EchoStar 12 to 86.4

1. Applicant

Name:	EchoStar Operating L.L.C.	Phone Number:	301-428-5893
DBA Name:		Fax Number:
Street:	100 Inverness Terrace East	E-Mail:

City:	Englewood	State:	CO
Country:	USA	Zipcode:	80112 -
Attention:	Jennifer Manner

2. Contact

Name:	Jennifer Manner	Phone Number:	301-428-5893
Company:	EchoStar Operating L.L.C.	Fax Number:
Street:	11717 Exploration Lane	E-Mail:	jennifer.manner@echostar.ccom

City:	Germantown	State:	MD
Country:	USA	Zipcode:	20876 -
Attention:		Relationship:	Same

(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 IB2017001701

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
08/21/2017

7. CityBlackhawk

8. Latitude
(dd mm ss.s h) 44 11 15.3 N

9. State SD

10. Longitude
(dd mm ss.s h) 103 20 9.7 W

11. Please supply any need attachments.

Attachment 1: Exhibit 1

Attachment 2:

Attachment 3:

12. Description. Seeking STA to move and operate EchoStar 12 at 86.4 WL, as well as operate certain earth stations for TT&C communications. See Exhibit 1.

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

14. Name of Person Signing
Jennifer A. Manner

15. Title of Person Signing
Senior Vice President, Regulatory Affairs

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.