Application Form SES-STA-INTR2019-03695

Application Form

This document pretains to SES-STA-INTR2019-03695 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:

60-day STA Extension to Continue Operation of New VSAT Remote Terminal Types

1. Applicant

Name:	Globecomm License Sub LLC	Phone Number:	631-457-1347
DBA Name:		Fax Number:
Street:	45 Oser Avenue	E-Mail:	[email protected]

City:	Hauppauge	State:	NY
Country:	USA	Zipcode:	11788 -
Attention:	John Flynn

2. Contact

Name:	Jennifer D. Hindin	Phone Number:	202-719-4975
Company:	Wiley Rein LLP	Fax Number:
Street:	1776 K Street NW	E-Mail:	[email protected]

City:	Washington	State:	DC
Country:	USA	Zipcode:	20006 -
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 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 CGV - Fixed Satellite VSAT System

5. Type Request

Use Prior to Grant

Change Station Location

Other

6. Requested Use Prior Date

7. CityHauppauge

8. Latitude
(dd mm ss.s h) 0 0 0.0

9. State NY

10. Longitude
(dd mm ss.s h) 0 0 0.0

11. Please supply any need attachments.

Attachment 1: Narrative

Attachment 2:

Attachment 3:

12. Description. Globecomm requests a 60−day extension of STA, beginning November 1, 2019, to continue operating six new, 1.2−meter VSAT remote terminal types under its VSAT earth station license (E000277) for communications with the AMC−21 satellite (S2676). Pursuant to Rule 1.62, Globecomm will continue to operate under the terms and conditions of its existing STA pending action on this renewal request.

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
John Flynn

15. Title of Person Signing
VP, Global Operations

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.