Application Form SES-STA-INTR2021-02302

Application Form

This document pretains to SES-STA-INTR2021-02302 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:

30-Day STA for E170089 to Perform TT&C for ASTRA 1D

1. Applicant

Name:	SES Americom, Inc.	Phone Number:	202-478-7143
DBA Name:		Fax Number:	202-478-7111
Street:	1129 20th Street NW	E-Mail:	petra.vorwig@ses.com
	Suite 1000
City:	Washington	State:	DC
Country:	USA	Zipcode:	20036 -
Attention:	Ms Petra A Vorwig

2. Contact

Name:	Kelsie Rutherford	Phone Number:	202-478-7191
Company:	SES	Fax Number:
Street:	1129 20th Street NW	E-Mail:	kelsie.rutherford@ses.com
	Suite 1000
City:	Washington	State:	DC
Country:	USA	Zipcode:	20036 -
Attention:		Relationship:

(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 CGX - Fixed Satellite Transmit/Receive Earth Station

5. Type Request

Use Prior to Grant

Change Station Location

Other

6. Requested Use Prior Date
07/09/2021

7. CityMt. Airy

8. Latitude
(dd mm ss.s h) 39 22 38.8 N

9. State MD

10. Longitude
(dd mm ss.s h) 77 4 53.0 W

11. Please supply any need attachments.

Attachment 1: Narrative

Attachment 2:

Attachment 3:

12. Description. SES Americom, Inc. respectfully requests earth station special temporary authority for a period of 30 days starting no later than July 9, 2021 to permit SES to use its E170089 earth station to communicate with the Luxembourg-authorized ASTRA 1D spacecraft solely for the purposes of providing TT&C for the satellite, which is located at 73 degrees W.L.

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
Petra A. Vorwig

15. Title of Person Signing
Vice President, Legal & Regulatory 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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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.