Application Form

This document pretains to SES-STA-20191031-01398 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:

Telesat Network Services, Inc. 613-748-8700
135 Routes 202/206 [email protected]
Bedminster NJ
USA 07921 -1538
Ms Elisabeth Neasmith

Joseph A. Godles 202-429-4900
Goldberg, Godles, Wiener & Wright LLP
1025 Connecticut Ave, NW E-Mail: [email protected]
Ste 1000
Washington DC
USA 20036 -
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. CityPort St. Lucie 8. Latitude
(dd mm ss.s h) 27 16 56.9 N
9. State FL 10. Longitude
(dd mm ss.s h) 80 28 58.4 W
11. Please supply any need attachments.
Attachment 1: Attachment 1 Attachment 2: Attachment 2 Attachment 3: Attachment 3
12. Description. Special Temporary Authority to operate the earth station to provide testing support for the T19V Ka-band gateway earth station TNSI is constructing in Middletown, VA (See FCC Callsign E160134). This antenna will transmit/receive test carrier signals via T19V to measure antenna patterns and the gateway antenna
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
Elisabeth Neasmith 		15. Title of Person Signing
Director, Spectrum Management & Development
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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