Application Form

This document pretains to SES-STA-INTR2021-02118 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:

KVH Industries, Inc. 401-845-8148
401-845-8116
50 Enterprise Center [email protected]
Middletown RI
USA 02842 -
Ms Felise Feingold

Bruce Olcott 202 879-3630
Jones Day
51 Louisiana Avenue, N.W. E-Mail: [email protected]
Washington DC
USA 20001 -
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
SESMOD2021031600516 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
06/07/2021
7. CityN/A 8. Latitude
(dd mm ss.s h)
0 0 0.0 N
9. State RI 10. Longitude
(dd mm ss.s h)
0 0 0.0 E
11. Please supply any need attachments.
Attachment 1: Antenna Patterns Attachment 2: Rad Haz Analysis Attachment 3:
12. Description. This application seeks an extension of STA file number SES-STA-20210322-00548 for an additional period of 60 days while the underlying application for modification of call sign E090001, file number SES-MOD-2021-0316-00516, remains pending.
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
Felise Feingold
15. Title of Person Signing
General Counsel
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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