Application Form SES-STA-INTR2019-01018

Application Form

This document pretains to SES-STA-INTR2019-01018 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:

Conrad MT Gateway STA Request

1. Applicant

Name:	SpaceX Services, Inc.	Phone Number:	202-649-2700
DBA Name:		Fax Number:
Street:	1155 F Street, N.W.	E-Mail:	[email protected]

City:	Washington	State:	DC
Country:	USA	Zipcode:	20004 -
Attention:	Ms Patricia Cooper

2. Contact

Name:	William M. Wiltshire	Phone Number:	202-730-1350
Company:	Harris, Wiltshire & Grannis LLP	Fax Number:	202-730-1301
Street:	1919 M Street, NW	E-Mail:	[email protected]
	Suite 800
City:	Washington	State:	DC
Country:	USA	Zipcode:	20036 -
Attention:		Relationship:	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 SESLICINTR201900878 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
05/01/2019

7. CityConrad

8. Latitude
(dd mm ss.s h) 42 12 11.9 N

9. State MT

10. Longitude
(dd mm ss.s h) 111 56 43.0 W

11. Please supply any need attachments.

Attachment 1: Gateway STA Request

Attachment 2:

Attachment 3:

12. Description. SpaceX Services seeks special temporary authority for communications between its Ku-band gateway earth station and the first tranche of SpaceX NGSO satellites for 60 days after orbital injection.

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
Patricia Cooper

15. Title of Person Signing
Vice President, Satellite Government Affairs

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.