Transcription of NCVEC QUICK-FORM 605 APPLICATION AMATEUR …
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NCVEC QUICK-FORM 605 APPLICATION AMATEUR …
NCVEC QUICK-FORM 605 APPLICATIONAMATEUR operator / primary station LICENSESECTION 1 - TO BE COMPLETED BY APPLICANTPRINT LAST NAMESUFFIX (Jr., Sr.)FIRST CALL SIGN (IF LICENSED)MAILING ADDRESS (Number and Street or Box)FEDERAL REGISTRATION NUMBER (FRN) - IF NONE,THEN SOCIAL SECURITY NUMBER (SSN)CITYSTATE CODEZIP CODE (5 or 9 Numbers)DAYTIME TELEPHONE NUMBER (Include Area Code)E-MAIL ADDRESS (MANDATORYTO RECEIVE LICENSENOTIFICATIONEMAILFROM FCC)Basic QualificationQuestion:Has the Applicant or any party to this APPLICATION , or any party directly or indirectly controlling the Applicant, ever been convicted of afelony by any state or federal court?YESNOIf YES , see FCC BASIC QUALIFICATION QUESTION INSTRUCTIONS AND PROCEDURES on the back of this HEREBY APPLY FOR(Make an X in the appropriate box(es)):EXAMINATIONfor a new license grantEXAMINATION forupgradeof my license classCHANGE mynameon my license to my new nameFormer Name:(Last name) (Suffix)(First name)(MI)CHANGEmy mailing address toaboveaddressCHANGEmy stationcall signsystematicallyApplicant s Initials: To ConfirmRENEWALof my license grantExp.
ncvec quick-form 605 application amateur operator/primary station license section 1 - to be completed by applicant print last name suffix (jr., sr.) first name m.i. station call sign (if licensed)
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