FCC Form 605, Sche Instructions for Schedule for Additional Data for the Co

FCC 605 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB

Schedule E 3060 - 0850

See 605 Main Form Instructions

Information and Instructions for public burden estimate

Instructions for Schedule for Additional Data for the Commercial Radio, Restricted Radiotelephone, and

Restricted Radiotelephone-Limited Use Radio Services

Form FCC 605, Schedule E, is a supplementary schedule for use with the FCC Quick-Form Application for Authorization in the Ship, Aircraft, Amateur, Restricted and Commercial Operator, and the General Mobile Radio Services, FCC 605 Main Form. This schedule is used to apply for the required license authorization for the Commercial Radio, Restricted Radiotelephone, and Restricted Radiotelephone-Limited Use Radio Services. The FCC 605 Main Form must be filed in conjunction with this schedule.

Schedule E

Instructions

License Type/Endorsements Information

Item 1 & Item 1a Operator Class Code Check only one license type. Do not apply for more than one kind of license on a single application.

Applicants for new or modified authorizations other than Restricted Radiotelephone Operator Permits must attach an original Proof of Passing Certificate(s) from a certified Commercial Radio Operator License Examination Manager (COLEM) and/or copies of other documents showing that the applicant is eligible for examination credit.

If requesting consolidation of valid GMDSS Operators license and GMDSS Maintainers license check the GMDSS Radio Operator/Maintainer license block and enter your GMDSS Maintainer license serial number in item 1a. Please Note: Your GMDSS Operator license serial number must be entered in item 5 on the Main Form.

If you hold a valid GMDSS Operators or Maintainers license and are requesting a GMDSS Operator/Maintainer license by way of passing additional examination elements, check the GMDSS Operator/Maintainer license block and attach an original Proof of Passing Certificate.

Item 2 Endorsement Type Check endorsements that apply. You must submit the required documentation. If Ship Radar Endorsement is checked, the required documentation is an original Proof of Passing Certificate(s) from a certified COLEM. If Six Months Service Endorsement is checked, you must submit the required documentation as required by Rule Section 13.9 (e) and, if necessary, copies of other documents that show the applicant is eligible for examination credit.

Item 3 Certification Category Complete eligibility of employment in the United States, enter your date of birth (mm/dd/yyyy format), and check one of the three certifications.

Note: The date of birth will not be made available for public inspection.

Certification Statements By signing the Main Form, the applicant certifies that the statements listed in this section are true, correct, and made in good faith.

Special Instructions For Radiotelegraph Applicants

Include with your application for all purposes except ‘CA’ & ‘WD’, TWO identical passport type photographs taken within the past six months.

Photographs must be:

~Signed by the applicant on the front along the left side. Signature must be clearly visible;

~2 x 2 inches in size;

~Clear, full face (head and shoulders only).

Photographs are acceptable in black and white or color with a light, plain background. Large photos that cannot be cropped are not acceptable. Enclose your photos in a plain envelope. Write the word “PHOTOS” and your name on the outside. Staple the envelope to the back of your applications.

FCC 605 Schedule for Additional Data for the Commercial Radio, Approved by OMB

Schedule E Restricted Radiotelephone, and 3060 - 0850

Restricted Radiotelephone-Limited Use Radio Services See 605 Main Form Instructions

for public burden estimate

LICENSE TYPE / ENDORSEMENTS INFORMATION

1) Operator Class Code: Check only one operator class -Do not apply for more than one kind of license on a single application.

	General Radiotelephone Operator License (PG)			First Class Radiotelegraph Operator's Certificate (T1)
	GMDSS Radio Operator's License (DO)			Second Class Radiotelegraph Operator's Certificate (T2)
	GMDSS Radio Maintainer's License (DM)			Third Class Radiotelegraph Operator's Certificate (T3)
	GMDSS Radio Operator/ Maintainer License (DB)			Restricted Radiotelephone Operator Permit (RR)
	GMDSS Restricted Radio Operator License (RG)			Restricted Radiotelephone Operator Permit-Limited Use (RL)
	Marine Radio Operator Permit (MP)

1a) If requesting consolidation of DO & DM Operator licenses, enter serial number of DM: __________________________________

2) Endorsement Type (Check endorsements that apply)

	Ship Radar Endorsement (Attach documentation.) (See instructions).
	Six Months Service Endorsement (Attach documentation as required by 47 C.F.R. § 13.9(e)). (See Instructions).

3. Certification Category

Are you eligible for employment in the United States? YES NO Date of Birth: _____(mm)/_____(dd)/_____(yyyy)

Check only ONE of the three certification categories below, as appropriate

	CERTIFICATION FOR LICENSES AND ENDORSEMENTS OTHER THAN RESTRICTED RADIOTELEPHONE
I certify that: I do not have a speech impediment, blindness, acute deafness, or any other disability which will impair or handicap me in properly using the license for which I am applying.

OR

CERTIFICATION FOR RESTRICTED RADIOTELEPHONE OPERATOR PERMIT

I certify that: I can keep at least a rough written log. I can speak and hear. I am familiar with the provisions of the applicable laws, treaties, rules, and regulations governing the radio station which will be operated. I need this permit because of intent to engage in international voyages or flights, international communications, or intent to comply with the requirements of the Vessel Bridge-to-Bridge Radiotelephone Act.

OR

CERTIFICATION FOR RESTRICTED RADIOTELEPHONE OPERATOR PERMIT-LIMITED USE

I certify that: I can keep at least a rough written log. I can speak and hear. I am familiar with the provisions of the applicable laws, treaties, rules, and regulations governing the radio station which will be operated. I need this permit because of intent to engage in international voyages or flights, international communications, or intent to comply with the requirements of the Vessel Bridge-to-Bridge Radiotelephone Act. I hold an aircraft pilot certificate which is valid in the United States or an FCC Radio Station License issued in my name. I am NOT eligible for employment in the United States.  (All U.S. citizens are considered, for the purposes of this application, to be legally eligible for employment in the U.S.)

FCC 605 Schedule E

Edition Date – Page 1