Application Form

This document pretains to SES-STA-20190605-00727 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:

Production & Satellite Services, Inc. 702-553-1820
702-895-7484
4415 Wagon Trail Ave [email protected]
Las Vegas NV
USA 89118 -
Mr Brian S Nelles

Brian Nelles 702-553-1820
PSSI Global Services LLC 702-895-7484
4415 Wagon Trail Avenue E-Mail: [email protected]
Las Vegas NV
USA 89118 -
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 only one.)
3. Reference File Number
SESMOD2019051600616 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 CGB - Mobile Satellite Earth Stations
5. Type Request
Use Prior to Grant Change Station Location Other
6. Requested Use Prior Date
06/01/2019
7. CityOrlando 8. Latitude
(dd mm ss.s h)
28 28 36.3 N
9. State FL 10. Longitude
(dd mm ss.s h)
81 22 21.6 W
11. Please supply any need attachments.
Attachment 1: Attachment 2: Attachment 3:
12. Description. Applicant desires to perform testing from a licensed transportable earth station, call sign E130126, prior to FCC granting authorization to add frequency and emission designator modifications.
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
Brian S Nelles
15. Title of Person Signing
Executive Vice President
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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