Application Form

This document pretains to SES-STA-INTR2019-01417 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:

GCI Communication Corp. 907-868-5615
907-868-9817
2550 Denali St, Ste 1000 [email protected]
Anchorage AK
USA 99503 -2737
Ms Cynthia L Hall

GCI Communication Corp. 907-868-5615
907-868-9817
2550 Denali St, Ste 1000 E-Mail: [email protected]
Anchorage AK
USA 99503 -2737
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 IB2019001415
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
05/10/2019
7. CityKotlik 8. Latitude
(dd mm ss.s h)
63 2 7.76 N
9. State AK 10. Longitude
(dd mm ss.s h)
163 31 55.49 W
11. Please supply any need attachments.
Attachment 1: Exhibit A Attachment 2: Attachment 3:
12. Description. Point to point data network
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
Chris Mace
15. Title of Person Signing
VP, Network Services and Chief 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.


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