FCC Form 312 - Sch Satellite Earth Station Authorizations

Pending Approval by OMD
3060-0678

SATELLITE EARTH STATION AUTHORIZATIONS
FCC Form 312 - Schedule A
FOR OFFICIAL USE ONLY

[INSTRUCTIONS]
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CONSENT TO TRANSFER OF CONTROL

CONSENT TO ASSIGNMENT OF LICENSE

NOTIFICATION OF TRANSFER OF CONTROL OF
RECEIVE ONLY REGISTRATION

NOTIFICATION OF ASSIGNMENT OF
RECEIVE ONLY REGISTRATION

A1. Name of Licensee (as shown on FCC 312 - Main Form)
Name:

Phone Number:

DBA
Name:

Fax Number:

Street:

E-Mail:

City:

State:

Country:

USA





-

Zipcode:

Attention:
A8. List Callsign(s) of station(s) being assigned or transfered
Enter Call Sign(s)

A9. No. of station(s) listed

A10. Name of Transferor / Assignor
Name:

Phone Number:

Company:

Fax Number:

Street:

E-Mail:

City:

State:

Country:

USA

Contact
Title:



Zipcode:
Relationship:

A15. Name of Transferee/ Assignee
Name:

Phone Number:

DBA
Name:

Fax Number:

Street:

E-Mail:

City:

State:

Country: USA

Zipcode:





Attention:
A20. If these facilities are licensed, is the transferee / assignee directly or indirectly controlled
by any other entity? If yes, attach as Exhibit E, a statement (including organizational diagrams
where appropriate) which fully and completely identifies the nature and extent of control
including: (1) the name, address, citizenship, and primary busienss of the controlling entity and
any intermediate subsidiaries or parties, and (2) the names, addresses, citizenshihp, and the
percentages of voting and equity stock of those stockholders holding 10 percent or more of the
controlling corporation's voting stock.

Yes
No
N/A
Attachment

A21. If these facilities are licensed, attach as Exhibit F, a complete statement setting forth the
facts which show how the assignment or transfer will serve the public interest.

Attachment

CERTIFICATION
1. The undersigned, individually and for licensee, certifies that all attached exhibits pertinenet to Schedule A and all
statement made in Schedule A of this application are true, compete and correct to the best of his/her knowledge and
belief. The undersigned also certifies that any contracts or other instruments submitted herewith are complete and
constitute the full agreement.
2. The undersigned represents that stock will not be delivered and that control will not be transferred until the
Commission's consent has been received, but that transfer of control or assignment of license will be completed within
60 days of Commission consent. The undersigned also acknowledges that the Commission must be notified by letter
within 30 days of consummation.
A22. Printed Name of Licensee (Must agree with A1)

A24. Title (Office Held by Person Signing)

A26. Printed Name of License Transferor / Assignor
(Must agree with A10)

A28. Title (Office Held by Person Signing)

A26. Printed Name of License Transferee / Assignee
(Must agree with A15)

A28. Title (Office Held by Person Signing)

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SATELLITE EARTH STATION AUTHORIZATIONS
FCC Form 312 - Schedule A
FOR OFFICIAL USE ONLY

[INSTRUCTIONS]
1 copy of this form section exist.
Callsign:
Callsign:
Callsign:
Callsign:
Callsign:

Callsign:
Callsign:
Callsign:
Callsign:
Callsign:
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FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT
The public reporting for this collection of information is estimated to average 9 hours per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the required
data, and completing and reviewing the collection of information. If you have any comments on this burden
estimate, or how we can improve the collection and reduce the burden it causes you, please write to the Federal
Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0678), Washington, DC
20554. We will also accept your comments regarding the Paperwork Reduction Act aspects of this collection
via the Internet if you send them to [email protected]. PLEASE DO NOT SEND COMPLETED FORMS TO THIS
ADDRESS.
Remember - You are not required to respond to a collection of information sponsored by the Federal
government, and the government may not conduct or sponsor this collection, unless it displays a currently
valid OMB control number or if we fail to provide you with this notice. This collection has been assigned an
OMB control number of 3060-0678.
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.