Attachment SES-STA-20180815-022

SES-STA-20180815-022

DECISION submitted by FCC

Grant

0000-00-00

This document pretains to SES-STA-20180815-02233 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2018081502233_1510989

E880547 SES—STA—20180815—02233 182018004827 WALGREEN CO. Approved by OMB 3060—0678 APPLICATION FOR EARTH STATION SPECIAL TEMPORARY AUTHORITY APPLICANT INFORMATIONEnter a descriptionof this application to identify it on the main menu: Extension Request for STA — SES—STA—20180615—01080 1. Applicant Name: WALGREEN CO. Phone Number: 224—542—6880 DBA Name: Fax Number: Street: 1084 MOUNT PROSPECT E—Mail: fred.pino@walgreens.com PLAZA City: MT PROSPECT State: IL Country: USA Zipcode: 60056 = Attention: MrFRED PINO ooo % sChnooKERS—GHN—3 L3 w_— C ~ is(3 ca11(§?g%gb_\\gamt Date?g_“}_\__\(é |— tS Z (or other identifier) | csayrep | GranTeD From: |r——R®RNRET1Waze.. . 3. 30Y International Bureau { > Approved;

2. Contact Name: FRED PINO Phone Number: 224—542—6880 Company: WALGREEN CO. Fax Number: Street: 1084 MOUNT PROSPECT E—Mail: fred.pino@walgreens.com PLAZA City: MT PROSPECT State: IL Country: USA Zipcode: 60056 — 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 ouly one.) 3. Reference File Number or Submission ID 1B2018002655 4a. Is a fee submitted with this application? @© IfYes, complete and attach FCC Form 159. If No, indicate reason for fee exemption (see 47 C.F.R.Section 1.1114). C3 Governmental Entity 3 Noncommercial educational licensee C Other(please explain): 4b. Fee Classification —CGV — Fixed Satellite VSAT System 5. Type Request y Use Prior to Grant g4 Change Station Location «4 Other 6. Requested Use Prior Date 08/21/2018

7. CityMT PROSPECT 8. Latitude (dd mm ss.s h) 42 4 8.0 N 9. State IL 10. Longitude (dd mm ss.s h) 87 55 6.0 W 11. Please supply any need attachments. Attachment 1: Attachment 2: Attachment 3: 12. Description. (If the complete description does not appear in this box, please goto the end of the form to view it in its entirety.) Current STA (SES—STA—20180615—01080) will expire on 08/21/2018. Requesting extension of current STA due to license modification SES—MOD—20180615—01081 recently being accepted for for Public Notice due to other C Band registration applications taking priority. 13. By checking Yes, the undersigned certifies that neither applicant nor any other party to the applicationis Yes «y 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 Fred Pino Technical Architect 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).

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 maintainingthe 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 PRAQ@fce.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 LA&AW 104—13, OCTOBER 1, 1995, 44 U.S.C. SECTION 3507.

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Document Created: 2019-05-15 19:15:11
Document Modified: 2019-05-15 19:15:11
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