Attachment STA Request

This document pretains to SES-STA-20181011-03186 for Special Temporal Authority on a Satellite Earth Station filing.

IBFS_SESSTA2018101103186_1551196

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 Extension Using Hagerstown, Maryland Earth Station KA258 to Provide LEOP Services for SES−12 1. Applicant Name: Intelsat License LLC Phone Number: 703−559−7848 DBA Name: Fax Number: 703−559−8539 Street: c/o Intelsat US LLC E−Mail: susan.crandall@intelsat.com 7900 Tysons One Place City: McLean State: VA Country: USA Zipcode: 22102 −5972 Attention: Susan H. Crandall 1

2. Contact Name: Cynthia J. Grady Phone Number: 703−559−6949 Company: Intelsat US LLC 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. CityHagerstown 8. Latitude (dd mm ss.s h) 39 35 54.6 N 2


Document Created: 2018-10-10 16:26:14
Document Modified: 2018-10-10 16:26:14
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