Application Form SES-STA-20191001-01254

Application Form

This document pretains to SES-STA-20191001-01254 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:

60-day STA Extension (Chenega)

1. Applicant

Name:	Alaska Communications Internet, LLC	Phone Number:	907-297-3000
DBA Name:		Fax Number:	907-297-3153
Street:	600 Telephone Avenue	E-Mail:	Lisa.Phillips@acsalaska.com
	MS #60
City:	Anchorage	State:	AK
Country:	USA	Zipcode:	90503 -
Attention:	Ms. Lisa Phillips

2. Contact

Name:	Richard Cameron	Phone Number:	2022304962
Company:	LMI Advisors	Fax Number:
Street:	2550 M Street NW	E-Mail:	rcameron@lmiadvisors.com
	Suite 343
City:	Washington	State:	DC
Country:	USA	Zipcode:	20037 -
Attention:		Relationship:	Other

(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 SESSTA2019071200914 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
10/06/2019

7. CityChenega

8. Latitude
(dd mm ss.s h) 60 3 56.3 N

9. State AK

10. Longitude
(dd mm ss.s h) 148 1 1.6 W

11. Please supply any need attachments.

Attachment 1: Draft 312 Schedule B

Attachment 2: Technical Appendix

Attachment 3: Narrative

12. Description. 60-day STA to operate a C-band earth station in Chenega Bay.

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
Rick Benken

15. Title of Person Signing
VP

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 FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104-13, OCTOBER 1, 1995, 44 U.S.C. SECTION 3507.