Application Form

This document pretains to SES-STA-20211130-01849 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:

Universal Space Network, Inc. 215-328-9130
215-328-9132
417 Caredean Drive [email protected]
Suite A
Horsham PA
USA 19044 -
Dave Massey

Universal Space Network 215-328-9130
215-328-9132
417 Caredean Drive E-Mail: [email protected]
Suite A
Horsham PA
USA 19044 -
Engineer
(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
01/17/2022
7. CityNorth Pole 8. Latitude
(dd mm ss.s h) 64 48 15.3 N
9. State AK 10. Longitude
(dd mm ss.s h) 147 30 0.8 W
11. Please supply any need attachments.
Attachment 1: FCC312 Attachment 2: Narrative-waiver Attachment 3: Comsearch
12. Description. SSC Space US (dba Universal Space Network) a Delaware corporation request a special temporary authority to support testing of the WL2XOU (Linus), a US spacecraft mission from the Alaskan earth station in preparation for LEOP support of the mission. This STA is requested to start on January 17th, 2022 for a period of 30 days/
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
Dave Massey 		15. Title of Person Signing
Chief Technologist
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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