From 159

0211-EX-RR-2012 Post Grant Documents

Sirius Satellite Radio Inc.

2014-03-10ELS_146740

tANKlFOc JUN29 2012 !2_O7OS7O9JJ9-O/ READ INSTRUCTIONS CAREFULLY Approved by 0MB BEFORE PROCEEDING FEDERAL COMMUNICATIONS COMMISSION 3060-0589 REMITTANCE ADVICE Page No' of' (I) LOCKBOX 8 SPECI L 83SF ONLY 979095 FCcLSEONLY SECTION A- PAYER INFORMATION (2) PAYERNAME (ifpaying by credit card enlername exactly as it appears onthe card) (3) TOTAL AMOUNT PAID (U.S. Dollars and rents) Sirius XN Radio Inc. $60.00 (4) STREET ADDRESS LINE NO.1 1221 Avenue of the americas (5) STREET ADDRESS LINE NO. 2 36th Floor (61 CITY (7) STATE (8) ZIP CODE New York NY 10020 (9) DAYTIME TELEPHONE NUMBER (include area code) (10) COUNTRY CODE (if not in U.S.A.) 212-5845100 Us FCC REGISTRATION NUMBER (FRN) REQUIRED (11) PAYER (FRN) (12) FCC USE ONLY 0006345730 IF MORE THAN ONE APPLICANT, USF CONTINUATION ShEETS (FORM I c9-C) COMPLETE SECTIONBELOW FOR EACH SERVICE, IF MORE BOXES ARE NEEDED. USE CONTINUATION SHEET (13) APPLICANT NAME Sirius Satellite Radio Inc. (14) STREET ADDRESS LINE NO.1 James S. Blitz (15) STREET ADDRESS LINE NO. 2 1500 Eckington Place NE (16)CITY (I7)STATE (18)ZIPCODE Washington DC 20002 (19) DAYTIME TELEPHONE NUMBER (include area code) (20) COUNTRY CODE (if not in U.S.A.) 212-584-5100 US FCC REGISTRATION NUMBER (FRN) REQUIRED (21) APPLICANT (FRN) (2211-CC USE ONLY 0006345730 COMPLETE SECTION C FOR EACH SERVICE, I MORE BOXES ARE NEEDED, USE CONTINUATION SHEE1 (23A) CALL SIGN/OTHER ID (24A) PAYMENT TYPE CODE (25,) QUANTITY 0211RR2012 EPE 1 (26A) FEE DUE FOR (FTC) (27A) TOTAL FEE 1-UC USE ONLY $60.00 $60.00 (28M FCC CODE I (29A) FCC CODE 2 13EL385374 (23B) CALL SIGN/OTHER ID (24B) PAYMENT TYPE CODE (25B) QUANTITY (26B) FEE DUE FOR (PTC) (27B) TOTAL FEE I-CC USE ONLY (28B)FCC CODE I (29B) FCC CODE 2 SECTION D - CERTIFICATION CERTIFICATION STATEMENT I, ,certify under penalty ofperjury that the foregoing and supporting information is true and correct to the best of my knowledge, information and belief. SIGNATURE________________________________________________ DATE____________________ SECTION E - CREDIT CARD PAYMENT INFORMATION MASTERCARD VISA_____ AMEX_____ DISCOVER_____ ACCOUNT NUMBER_________________________________________ EXPIRATION DATE ____________________________ I hereby authorize the FCC to charge my credit card for the service(s)/authorizaticet herein described. SIGNATURE________________________________________________________ DATE____________________________ SEE PUBLIC BURDEN ON REVERSE FCC FORM 159 FEBRUARY 2003(REVISED)


Document Created: 2014-03-10 11:53:28
Document Modified: 2014-03-10 11:53:28
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