Application Form

This document pretains to SES-STA-INTR2005-02761 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:

Chesapeake Satellite, Inc. 304-876-8309
304-876-1364
698 Dam 4 Road [email protected]
Shepherdstown WV
USA 25443 -
Mrs Judith Ackermann

Mrs Judith Ackermann 304-876-8309
Chesapeake Satellite, Inc. 304-876-1364
698 Dam 4 Road E-Mail: [email protected]
Shepherdstown WV
USA 25443 -
Judith Ackermann 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
or Submission ID IB2005002760
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
12/12/2005
7. City 8. Latitude
(dd mm ss.s h)
0 0 0.0
9. State 10. Longitude
(dd mm ss.s h)
0 0 0.0
11. Please supply any need attachments.
Attachment 1: STA Description 3.7m Attachment 2: Attachment 3:
12. Description. Existing earth station license (call sign E950462) is due to expire on 12/08/2005. Previous plans to retire the earth station from revenue use have changed with the emergence of a purchaser for this system who will need it to be in service by mid December 2005. Renewal for the original license has been submitted and a modification has been submitted that adds necessary emission designators and increased uplink EIRP required by the purchaser. This STA is requested to cover the purchaser
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
Judith Ackermann
15. Title of Person Signing
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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