Application Form SES-STA-INTR2018-10421

Application Form

This document pretains to SES-STA-INTR2018-10421 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:

WMOT-FM STA PENDING RENEWAL OF SES-REG-20031124-01701

1. Applicant

Name:	MIDDLE TENNESSEE STATE UNIVERSITY	Phone Number:	615-898-2800
DBA Name:		Fax Number:	615-898-2774
Street:	1500 Greenland Drive	E-Mail:	gbrown@mtsu.edu
	Box 3
City:	Murfreesboro	State:	TN
Country:	USA	Zipcode:	37221 -
Attention:	Mr Gary Brown

2. Contact

Name:	GARY BROWN	Phone Number:	615-898-2791
Company:	MIDDLE TENNESSEE STATE UNIVERSITY	Fax Number:
Street:	BOX 3	E-Mail:	GBROWN@MTSU.EDU

City:	MURFREESBORO	State:	TN
Country:	USA	Zipcode:	37132 -
Attention:		Relationship:	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 SESRWLINTR201810419 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 CGS - Fixed Satellite Small Transmit/Receive Earth Station

5. Type Request

Use Prior to Grant

Change Station Location

Other

6. Requested Use Prior Date
12/03/2018

7. CityMURFREESBORO

8. Latitude
(dd mm ss.s h) 35 51 2.0 N

9. State TN

10. Longitude
(dd mm ss.s h) 86 21 44.0 W

11. Please supply any need attachments.

Attachment 1:

Attachment 2:

Attachment 3:

12. Description. THIS IS A REQUEST FOR CONTINUED PROTECTION OF CBAND DOWNLINK RECEIVE ANTENNA ASSOCIATED WITH RADIO STATION WMOT-FM, PENDING RENEWAL OF CALLSIGN E030325. THE FACILITY IS USED FOR RECEPTION OF NATIONAL PUBLIC RADIO SERVICES. A RENEWAL APPLICATION HAS BEEN SUBMITTED.

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
GARY BROWN

15. Title of Person Signing
ENGINEER

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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Remember - You are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-0678.

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.