Application Form [pdf]

This document pretains to SES-LIC-20130725-00666 for License on a Satellite Earth Station filing.

IBFS_SESLIC2013072500666_1005218

Approved by OMB 3060−0678 Date & Time Filed: Jul 25 2013 1:44:33:733PM File Number: SES−LIC−INTR2013−01620 Callsign/Satellite ID: APPLICATION FOR EARTH STATION AUTHORIZATIONS FCC Use Only FCC 312 MAIN FORM FOR OFFICIAL USE ONLY APPLICANT INFORMATION Enter a description of this application to identify it on the main menu: License for a 2.4 meter C−band T/R at Indian Mtn LRRS, Alaska 1−8. Legal Name of Applicant Name: UltiSat, Inc. Phone Number: 240−813−7586 DBA Fax Number: Name: Street: 708 Quince Orchard Rd. E−Mail: dbryant@ultisat.com Suite 120 City: Gaithersburg State: MD Country: USA Zipcode: 20878 − Attention: Mr David Bryant 1

9−16. Name of Contact Representative Name: Mr David Bryant Phone Number: 240−813−7586 Company: UltiSat, Inc. Fax Number: Street: 708 Quince Orchard Rd E−Mail: dbryant@ultisat.com Suite 120 City: Gaithersburg State: MD Country: USA Zipcode: 20878− Attention: Relationship: 2

CLASSIFICATION OF FILING 17. Choose the button next to the b. classification that applies to this filing for b1. Application for License of New Station both questions a. and b. Choose only one b2. Application for Registration of New Domestic Receive−Only Station for 17a and only one for 17b. (N/A) b3. Amendment to a Pending Application a. (N/A) b4. Modification of License or Registration a1. Earth Station (N/A) b5. Assignment of License or Registration (N/A) b6. Transfer of Control of License or Registration (N/A) a2. Space Station (N/A) b7. Notification of Minor Modification (N/A) b8. Application for License of New Receive−Only Station Using Non−U.S. Licensed Satellite (N/A) b9. Letter of Intent to Use Non−U.S. Licensed Satellite to Provide Service in the United States b10. Other (Please specify) b11. Application for Earth Station to Access a Non−U.S.satellite Not Currently Authorized to Provide the Proposed Service in the Proposed Frequencies in the United States. b12. Application for Database Entry (N/A) b13. Amendment to a Pending Database Entry Application (N/A) b14. Modifiction of Database Entry 17c. 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): 17d. Fee Classification BAX − Fixed Satellite Transmit/Receive Earth Station 3


Document Created: 2019-04-17 01:14:47
Document Modified: 2019-04-17 01:14:47
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