Application Form

This document pretains to SES-STA-INTR2021-02267 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:

SES Americom, Inc. 202-478-7143
202-478-7111
1129 20th Street NW petra.vorwig@ses.com
Suite 1000
Washington DC
USA 20036 -
Ms Petra A Vorwig

Jack Narciso 609-480-5375
SES Americom, INC.
4 Research Way E-Mail: jack.narciso@ses.com
Princeton NJ
USA 08540 -
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 SESMFS2021042300730 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
07/03/2021
7. CitySunset Beach Honolulu 8. Latitude
(dd mm ss.s h) 21 40 15.4 N
9. State HI 10. Longitude
(dd mm ss.s h) 158 1 56.4 W
11. Please supply any need attachments.
Attachment 1: Attachment 2: Attachment 3:
12. Description. SES Americom Inc. respectfully requests to extend earth station special temporary authority for a period of 60 days beginning no later than July 3rd 2021 to permit SES to use its E960207 earth station to communicate with satellites on the FCC permitted list (Eutelsat 172B) pending grant of SESMFS2021042300730.
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
Jack Narciso 		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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