Application Form

This document pretains to SES-STA-20200827-00930 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:

Hawaii Pacific Teleport, L.P. 808-674-9157
808-674-1826
P.O. Box 429 lsmith-ryland@hawaiiteleport.com
Makawao HI
USA 96768 -
Ms Leeana A Smith-Ryland

Paul Feldman 7038120403
Fletcher Heald & Hidlreth
1300 North 17th St. E-Mail: feldman@fhhlaw.com
Arlington VA
USA 22209 -
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 SESMFS2020081800887 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
09/01/2020
7. CityPulanat 8. Latitude
(dd mm ss.s h) 13 25 4.8 N
9. State GU 10. Longitude
(dd mm ss.s h) 144 45 6.2 E
11. Please supply any need attachments.
Attachment 1: HPT STA Waiver Req. Attachment 2: Radhaz Attachment 3: Coordination report
12. Description. Hawaii Pacific Teleport seeks STA for its Guam earth station to transmit to and receive from SES-12, a Netherlands-licensed satellite, pending Commission processing of the pending application for permanent authority (SES-MFS-20200818-00887). STA is sought through
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
Leeana Smith-Ryland 		15. Title of Person Signing
CEO
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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