Application Form SES-STA-20171005-01109

Application Form

This document pretains to SES-STA-20171005-01109 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:

Request for Special Temporary Authority for a pending 3.8 meter C-band T/R earth station in Nelson Lagoon, AK.

1. Applicant

Name:	Optimera Inc.	Phone Number:	907-359-1121
DBA Name:		Fax Number:
Street:	P.O. Box 921134	E-Mail:	[email protected]

City:	Dutch Harbor	State:	AK
Country:	USA	Zipcode:	99692 -
Attention:	Emmett J Fitch

2. Contact

Name:	Emmett J Fitch	Phone Number:	907-359-1121
Company:	Optimera Inc.	Fax Number:
Street:	P.O. Box 921134	E-Mail:	[email protected]

City:	Dutch Harbor	State:	AK
Country:	USA	Zipcode:	99692 -
Attention:		Relationship:

(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 IB2017002810

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
10/10/2017

7. CityNelson Lagoon

8. Latitude
(dd mm ss.s h) 55 59 14.9 N

9. State AK

10. Longitude
(dd mm ss.s h) 160 34 32.6 W

11. Please supply any need attachments.

Attachment 1: Coordination report

Attachment 2:

Attachment 3:

12. Description. Special Temporary Authority for use prior to grant of pending license for a 3.8 meter C-band T/R earth station in Nelson Lagoon, Alaska. The STA is needed to provide emergency support to restore communications that were lost due to a local accident.

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
Emmett J Fitch

15. Title of Person Signing
CEO

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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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.