Application Form

This document pretains to SES-STA-20180824-02497 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:

The Ahmadiyya Movement in Islam, Inc. USA 301-332-3287
301-879-0222
MTA Teleport [email protected]
1440 Briggs Chaney Rd.
Silver Spring MD
USA 20905 -
Mr Munir Ahmad

Munir Ahmad 301-332-3287
The Ahmadiyya Movement in Islam, Inc. USA
1440 Briggs Chaney Rd E-Mail: [email protected]
Silver Spring MD
USA 20905 -
(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): Non-Profit Religious

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
10/01/2018
7. CityVarious 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: Operations Statement Attachment 2: Radhaz report Attachment 3:
12. Description. Special Temporary Authority for a 1.2 meter Ku-band transportable fixed earth station that will support temporary operation from 10/01/2018 thru 11/30/18 at various locations in support of the Applicant's non-profit religious Organization. The uplink will be used to backhaul religious sermons to the Applicant's Network Operations Center in Silver Spring, Maryland.
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 No
14. Name of Person Signing
Munir Ahmad
15. Title of Person Signing
Director Americas
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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