Application Form SES-STA-20181228-03575

Application Form

This document pretains to SES-STA-20181228-03575 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:

Renewal of Global 1-4 earth station STA p

1. Applicant

Name:	BlackSky Global, LLC	Phone Number:	206-399-2325
DBA Name:		Fax Number:
Street:	1505 Westlake Ave. North, Ste 600	E-Mail:	khloptsidis@SpaceflightIndustries.com

City:	Seattle	State:	WA
Country:	USA	Zipcode:	98109 -
Attention:	Ms Kristina Hloptsidis

2. Contact

Name:	Jonathan L. Wiener	Phone Number:	703-216-9224
Company:	Goldberg, Godles, Wiener & Wright LLP	Fax Number:
Street:	1025 Connecticut Ave, NW	E-Mail:	jwiener@g2w2.com
	Ste 1000
City:	Washington	State:	DC
Country:	USA	Zipcode:	20036 -
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 SESLIC2018060701260 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
01/17/2019

7. CityNorth Pole

8. Latitude
(dd mm ss.s h) 64 47 37.0 N

9. State AK

10. Longitude
(dd mm ss.s h) 147 32 10.0 W

11. Please supply any need attachments.

Attachment 1: Attachment 1

Attachment 2:

Attachment 3:

12. Description. STA to extend temporary operation granted Nov 15, 2018 (FCC File No. SES-STA-20181024-03112), due to expire Jan 17, 2019.

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
Peter Hisken

15. Title of Person Signing
Senior Legal Counsel

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 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 maintaining the required d ata, 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 PRA@fcc.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 LAW 104-13, OCTOBER 1, 1995, 44 U.S.C. SECTION 3507.