Application Form [pdf]

This document pretains to SES-STA-20190206-00075 for Special Temporal Authority on a Satellite Earth Station filing.


                                                                                                             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:
30−day Further Extension STA to Continue Using a Ku−band Flat−panel Antenna Located at McLean, Virginia Headquarters
    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




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    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. CityMcLean                                                             8. Latitude
                                                                              (dd mm ss.s h)    38   55    10.0   N


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    9. State   VA                                                              10. Longitude
                                                                               (dd mm ss.s h)     77   13   12.0   W
    11. Please supply any need attachments.
    Attachment 1: STA Request                         Attachment 2:                                      Attachment 3:


    12. Description.   (If the complete description does not appear in this box, please go to the end of the form to view it in its entirety.)
        Intelsat herein requests an additional 30 days of Special Temporary Authority to continue
        utilizing a Ku−band flat−panel antenna located at its McLean, Virginia headquarters to
        communicate with the Intelsat 29e satellite (S2913) at 50.0 W.L.




    13. By checking Yes, the undersigned certifies that neither applicant nor any other party to the application is               Yes            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
      Cynthia J. Grady                                                           Senior Counsel, Intelsat US LLC
               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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Document Created: 2019-04-26 04:10:33
Document Modified: 2019-04-26 04:10:33

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