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pdfFCC 605
Main Form
FEDERAL COMMUNICATIONS COMMISSION
Approved by OMB
3060 - 0850
Information and Instructions
Est. Avg. Burden
Per Response: .44 hours
Quick-Form Application for Authorization in the Ship, Aircraft, Amateur,
Restricted and Commercial Operator,
and General Mobile Radio Services
NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT OF 1974 AND
THE PAPERWORK REDUCTION ACT OF 1995
We have estimated that each response to this collection of information will take on average .44 hours. Our estimate includes the time
to read the instructions, look through existing records, gather and maintain required data, and actually complete and review the form or
response. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you,
please write the Federal Communications Commission, AMD-PERM, Washington, DC 20554, Paperwork Reduction Project (30600850). We will also accept your comments via the Internet if you send them to [email protected]. Please do not send completed
application forms to this address.
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 with this notice. This collection has been
assigned OMB control number 3060-0850.
The FCC is authorized under the Communications Act of 1934, as amended, to collect the personal information we request in this form.
We will use the information you provide to determine whether approving this application is in the public interest. If we believe there may
be a violation or potential violation of a statute, FCC regulation, rule or order, your application may be referred to the Federal, state, or
local agency responsible for investigating, prosecuting, enforcing or implementing the statute, rule, regulation or order. In certain
cases, the information in your application may be disclosed to the Department of Justice or a court or adjudicative body when (a) the
FCC; or (b) any employee of the FCC; or (c) the United States Government, is a party to a proceeding before the body or has an
interest in the proceeding.
All parties and entities doing business with the Commission must obtain a unique identifying number called the FCC Registration
Number (FRN) and supply it when doing business with the Commission. Failure to provide the FRN may delay the processing of the
application. This requirement is to facilitate compliance with the Debt Collection Improvement Act of 1996 (DCIA). The FRN can be
obtained electronically through the FCC webpage at http://wireless.fcc.gov/uls (click on CORES/CALL SIGN REGISTRATION) or by
manually submitting FCC Form 160. FCC Form 160 is available from the FCC’s web site at http://www.fcc.gov/formpage.html, by
calling the FCC’s Forms Distribution Center 800-418-FORM (3676), or from Federal Communications Commission Fax Information
System by dialing (202) 418-0177.
This notice is required by the Privacy Act of 1974, Public Law 93-579, December 31, 1974, 5 U.S.C. Section 552a(e)(3) and the
Paperwork Reduction Act of 1995, Public Law 104-13, October 1, 1995, 44 U.S.C. 3507.
FCC 605 - Instructions
May 2013 - Page 1
Overview
Purpose of Form
Form FCC 605 is a multi-purpose form. It is used to apply for
an authorization to operate radio stations, amend pending
applications, modify existing licenses, and perform a variety of
other miscellaneous transactions (refer to page 4 and 5 of
these instructions for a detailed list) in the Wireless
Telecommunications Bureau (WTB) radio services.
This
includes the Ship Radio, Aircraft Radio, Amateur Radio,
Restricted and Commercial Operator Radio, and the General
Mobile Radio [GMRS] Services. The purpose of this form is to
collect data pertaining to the proposed request. This data is
used by the FCC to determine whether the public interest
would be served by a grant of the request.
Introduction
FCC Form 605 is a multi-part form comprising a main form and
several schedules. Each application or amendment must
contain only one Main Form (Pages 1 and 2).
Main Form
The purpose of the Main Form is to obtain information
sufficient to identify the filer and establish the filer’s basic
eligibility and qualifications. The Main Form also contains the
required certification and signature block. The Main Form is
required for every application or amendment filed on FCC
Form 605.
Schedules
The purposes of the optional schedules are as follows:
Schedule A
The Schedule for Changes Affecting Multiple Call Signs or File
Numbers is used to submit global changes to items on the
FCC 605 Main Form that affect either multiple call signs or
multiple file numbers.
Schedule B
The Schedule for Additional Data for the Ship Radio Service
(47 CFR Part 80) is used to submit the required additional
parameters for ship stations including search & rescue
information. This schedule is used in conjunction with the Main
Form.
Schedule C
The Schedule for Additional Data for the Aircraft Radio Service
(47 CFR Part 87) is used to submit the required additional
parameters for aircraft stations. This schedule is used in
conjunction with the Main Form.
Schedule D
The Schedule for Additional Data for the Amateur Radio
Service (47 CFR Part 97) is used to submit the required
additional parameters for amateur stations. This schedule is
used in conjunction with the Main Form.
Schedule E
The Schedule for Additional Data for Commercial Radio
Operators, Restricted Radiotelephone, and Restricted
Radiotelephone-Limited Use Radio Services (47 CFR Part 13)
is used to submit the required additional parameters for these
licenses and permits. This schedule is used in conjunction
with the Main Form.
Schedule F
The Temporary Operator Permit for the Ship, Aircraft,
Restricted Radiotelephone, Restricted Radiotelephone-Limited
Use, and GMRS Radio Services is used to obtain a Temporary
Operator Permit while the Applicant's application is being
processed by the Commission. This schedule can only be
completed and retained by the Applicant upon submission of a
completed and signed FCC 605 Main Form and appropriate
Additional Data Schedule to the FCC.
Schedule G
The Schedule for Exemption From Ship Station Requirements
is used to supply information for exemption in the Ship Radio
Service (Part 80.59c). This schedule is used in conjunction
with the Main Form.
Schedules Required
ULS Form/Schedule Title
If you are applying for an authorization which
requires you to report additional data, file the
additional data schedule appropriate to the
service for which you are applying along with the
FCC 605 Main Form: Service
Ship Radio Service (47 CFR Part 80)
Main Form 605 - Quick-Form Application for Authorization
Schedule B - Schedule for Additional Data for the Ship Radio Service
Waiver request for Exemption from Ship Station
Requirements
Aircraft Radio Service (47 CFR Part 87)
Main Form 605 - Quick-Form Application for Authorization
Schedule G – Exemption from Ship Station Requirements
Main Form 605 - Quick-Form Application for Authorization
Schedule C - Schedule for Additional Data for the Aircraft Radio Service
Main Form 605 - Quick-Form Application for Authorization
Schedule D - Schedule for Additional Data in the Amateur Radio Service
Amateur Radio Service (47 CFR Part 97)
Commercial Radio Operator, Restricted
Radiotelephone, and Restricted RadiotelephoneLimited Use Radio Services (47 CFR Part 13)
General Mobile Radio Service [GMRS]
(47 CFR Part 95)
Main Form 605 - Quick-Form Application for Authorization
Schedule E - Schedule for Additional Data
Main Form 605 - Quick-Form Application for Authorization
FCC 605 - Instructions
May 2013 - Page 2
General Filing Instructions
Information Current and Complete
Information filed with the FCC must be kept current and complete. The Applicant must notify the FCC regarding any substantial and
significant changes in the information furnished in the application(s). See Section 1.65 of the Commission’s Rules.
Applicable Rules and Regulations
Applicants should obtain the relevant parts of the FCC’s rules in 47 CFR. Copies of 47 CFR may be purchased from the
Superintendent of Documents; Government Printing Office; Washington, DC 20402; (202) 512-1800. Refer also to the Government
Printing Office’s web site at http://www.access.gpo.gov.
Processing Fee and Filing Locations
A processing fee may be required with this form. The fee amounts are not specified on this form because they are reviewed and
updated on an annual basis. The fee amounts are provided in separate documents as follows:
Refer to Subpart G of Part 1 of the Code of Federal Regulations (47 CFR Part 1, Subpart G), the current Fee Filing
Guide, or FCC Form 1070Y. FCC Form 1070Y provides the fee information specifically for Form 605. For
assistance with fees applicable to the radio services governed by the FCC’s rules, call (877) 480-3201 (TTY 717338-2824). If you are required to submit payment with your manually filed application, you will also need FCC Form
159 (Fee Remittance Advice). The Fee Filing Guide, FCC Form 159 and FCC Form 1070Y can be downloaded
from the FCC’s web site at http://www.fcc.gov/formpage.html, by calling the FCC's Forms Distribution Center at
(800) 418-3676, or from FCC’s Fax Information System by dialing (202) 418-0177.
Paper applications requiring a fee must be mailed to Federal Communications Commission, P. O. Box 979097, St. Louis, MO,
63197-9000 or hand delivered to the U.S. Bank, Attn: FCC Government Lockbox #979097, SL-MO-C2-GL, 1005 Convention
Plaza, St. Louis, MO 63101.
Non-feeable paper applications should be mailed to Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA
17325-7245. Hand-deliveries and messenger-deliveries should be delivered to Federal Communications Commission, 1280 Fairfield
Road, Gettysburg, PA 17325.
Information on electronic filing is provided on Page 4 of these instructions.
Packages
If filing manually, the Main Form and the applicable schedules should be submitted as one package, stapled in the upper left corner.
The Main Form should be first with the schedules attached in alphabetical order. Applicants filing electronically are not required to
submit paper copies.
Paper Copies
The number of paper copies of this application required to be filed is one original. Applicants filing electronically are not required to
submit paper copies.
Exhibits
Each document required to be filed as an exhibit should be current as of the date of filing. Each page of every exhibit must be identified
with the number or letter of the exhibit, the number of the page of the exhibit, and the total number of pages of the exhibit. If material is
to be incorporated by reference, see the instruction on incorporation by reference.
Incorporation by Reference
You may incorporate by reference documents, exhibits, or other lengthy showings already on file with the FCC only if: the information
previously filed is more than one 8½” by 11” page in length, and all information therein is current and accurate in all significant respects;
the reference states specifically where the previously filed information can be found (i.e., station call sign and application file number,
title of proceeding, docket number and legal citations), including exhibit and page references. Use the relevant item number followed
by ‘A’. Items that call for numbers, or which can be answered ‘Y’ or ‘N’ or other short answers must be answered directly without
reference to a previous filing.
Waiver Requests
Requests for waiver must contain as an exhibit a statement of reasons sufficient to justify a waiver. The required showing must be
made for all rule waivers desired, identifying the specific rules or policies for which the waiver is requested. Refer to the current Fee
Filing Guide for fee requirements for waivers. For assistance with fees applicable to the radio services governed by the FCC’s rules,
call (877) 480-3201 (TTY 717-338-2824), or visit the web at http://esupport.fcc.gov.
FCC 605 - Instructions
May 2013 - Page 3
English to Metric Conversions
All distances must be provided as metric values. The following English to Metric equivalent should be used to convert distances
(rounded to the nearest tenth), where necessary:
1 foot
=
0.3048 meter
For Assistance
For assistance with this application, contact the Federal Communications Commission, call (877) 480-3201 (TTY 717-338-2824), or
visit the web at http://esupport.fcc.gov.
Electronic Filing
To file an application electronically, visit the FCC’s Internet site at http://wireless.fcc.gov/uls and select Online Filing. Interactive
instructions are provided for filing payment for an electronically filed application, including the amount and a Fee Remittance Advice.
On-line payment with a credit card is also available. For technical assistance with filing electronically call (877) 480-3201.
In instances where an Applicant files electronically and needs to include an exhibit(s) with the application and cannot transmit that
exhibit(s) to the FCC electronically, the Applicant may mail exhibits to the following address: Federal Communications Commission,
Application Exhibit, 1270 Fairfield Road, Gettysburg, PA 17325-7245. Hand deliveries and messenger deliveries should be delivered to
Federal Communications Commission, 1280 Fairfield Road, Gettysburg, PA 17325. Each exhibit should be clearly labeled with the
Applicant’s name, the 10-digit file number assigned to the application at the time of submission, and the type of exhibit (e.g. waiver
request).
Instructions for Form FCC 605 Main Form
FCC Form 605, Main Form, is used to obtain information sufficient to identify the filer and the purpose of the filing. The Main Form is
required for every application or amendment filed on FCC Form 605. Regardless of Purpose of Application, all items on the Main Form
must be completed according to the instructions below.
Radio Service Code
Item 1 You must enter the Radio Service Code for which the Applicant is filing or presently holds a license by inserting the appropriate
two-letter code from the following list:
Ship Radio Service (47 CFR Part 80)
Ship Recreational or Voluntarily Equipped ........................................................................................................................................................... SA
Ship Compulsory Equipped ................................................................................................................................................................................. SB
Ship Exemption……………………………………………………………………………………………………………………………………………………SE
Aircraft Radio Service (47 CFR Part 87)
Aircraft................................................................................................................................................................................................................. AC
Amateur Radio Service (47 CFR Part 97)
Amateur .............................................................................................................................................................................................................. HA
Vanity .................................................................................................................................................................................................................. HV
Commercial Radio Operators Services (47 CFR Part 13)
Restricted Radiotelephone .................................................................................................................................................................................. RR
Restricted Radiotelephone-Limited Use............................................................................................................................................................... RR
Commercial ......................................................................................................................................................................................................... CM
General Mobile Radio Service (47 CFR Part 95)
General Mobile Radio Service ............................................................................................................................................................................. ZA
Application Purpose
Item 2 You must indicate the purpose for which the application is being filed by inserting the appropriate two-letter abbreviation from the
following list. Only one purpose may be specified. For the General Mobile Radio Service [GMRS], effective January 1, 1989, 'new' or
'major modifications' may not be filed by business Applicants/Licensees.
NE - New: To request a new license. This purpose should only be used for initial applications. A change in vessel or aircraft
constitutes a need for a new license. Amateur applications with the purpose of NEW must be filed by a Volunteer Examiner
Coordinator. NOTE: SHIP EXEMPTION REQUESTS (SCHEDULE G) SHOULD BE FILED AS NEW AND PROVIDE CALL
SIGN IN ITEM 5.
FCC 605 - Instructions
May 2013 - Page 4
MD - Modification: To request a change in the conditions of any data for a license during the term of that license. Use Item 5
to provide the call sign (serial number for Commercial Operator License) of the affected station. The appropriate schedule
must be completed and attached, and must accurately describe the data that has been modified. See applicable Commission
Rules. Choose purpose MD if you are requesting consolidation of DO and DM (Commercial Operator). Choose purpose MD
if you are requesting a new systematic call sign be issued to you (Amateur operator).
Note:
After a license is modified, the FCC will issue a new license and previous versions of the license will no longer be
valid, regardless of the expiration date shown. License terms will not be extended as a result of an application for
Modification.
Note:
If the only changes desired are to administrative data, use the Administrative Update purpose instead of Modification
(see Administrative Update purpose below for further description of administrative updates).
RM - Renewal/Modification: To renew (within the specified renewal time frame, must be filed no later than expiration date of
the authorization and no sooner than 90 days prior to expiration date) an existing authorization and request a change in the
conditions for that authorization. Use Item 5 to provide the call sign (serial number for Commercial Operator License) of the
affected station. The appropriate schedule must be completed and attached, and must accurately reflect the data that has
been modified. If you wish to consolidate DO and DM (Commercial Operator) licenses and renew at the same time, choose
purpose RM.
Simple Application Purpose & Requirements for Paper Submission on FCC 605
RO - Renewal Only: To renew an existing authorization within the specified renewal time frame (must be filed no later than
expiration date of the authorization and no sooner than 90 days prior to expiration date) where no changes in the conditions
are being requested at the time of renewal.
(To make any modifications to your existing authorization, use the
Renewal/Modification purpose.)
Mandatory items required for submission of “RO” purpose are as follows:
Item 1) Radio Service Code
Item 2) Application/Licensee Purpose
Item 5) Call Sign/Serial # (if filing for multiple Call Signs/Serial #s,
list additional call signs/serial #s on Schedule A)
Item 9) FCC Registration Number (FRN)
Items 26 & 27) Fee Status
Items 28, 29 & 30) Signature and Date
Optional Items: Item 6) Requested Authorization Expiration Date
MM/DD
NOTE: To renew an existing STA, you must select purpose of ‘RM’ and enter the appropriate Call Sign in Item 5.
DU - Duplicate License: To request a hard copy duplicate of an existing license(s).
Mandatory items required for submission of “DU” purpose are as follows:
Item 1) Radio Service Code
Item 2) Application Purpose
Item 5) Call Sign/Serial # (if filing for multiple Call Signs/Serial #s,
list additional call signs/serial #s on Schedule A)
Item 9) FCC Registration Number (FRN)
Items 26 & 27) Fee Status
Items 28, 29 & 30) Signature and Date
Note: Requests for a Duplicate/Replacement Restricted Radiotelephone Operator Permit licensed prior to May 21, 2001
should be filed as purpose New (NE) and Schedule E will also be required.
AM - Amendment: To amend a previously-filed, currently pending application(s). Use Item 4 to provide the File Number(s) of
the affected pending application(s). The appropriate schedule must be completed and attached, and must accurately reflect
the amended data. See applicable Commission Rules.
AU - (No Fee Required) Administrative Update: To request a change of any administrative data on a license such as
Licensee name (without a change in ownership, control or corporate structure), mailing address, telephone and or fax
numbers, e-mail address, name of vessel and FAA Registration Number due to FAA change.
FCC 605 - Instructions
May 2013 - Page 5
Mandatory items required for submission of “AU” purpose are as follows:
Item 2) Application Purpose
Item 5) Call Sign/Serial # (if filing for multiple Call Signs/Serial #s,
list additional call signs/serial #s on Schedule A)
Item 9) FCC Registration Number (FRN)
Items 28, 29 & 30) Signature and Date
One or more of the following items may be corrected with “AU” purpose:
Item 11) Licensee Name (without a change in ownership) (also answer Item 13)
Item 12) Entity Name (without a change in ownership, control
or corporate structure) (also answer Item 13)
Item 13) Sale (or Transfer of Control) (for name change only)
Items 14 through 20) Mailing Address
Item 21) Telephone Number
Item 22) FAX Number
Item 23) E-Mail Address
Item 24) Vessel Name (applicable to Radio Service Codes SA or SB only)
Item 25) New FAA Registration number due to FAA change
Use Item 5 to provide the call sign (serial number for Commercial Operator License) of the affected station.
CA – (No
Fee Required) Cancellation of License: To cancel an existing license.
Mandatory items required for submission of “CA” purpose are as follows:
Item 2) Application Purpose
Item 5) Call Sign/Serial # (if filing for multiple Call Signs/Serial #s,
list additional call signs/serial #s on Schedule A)
Item 9) FCC Registration Number (FRN)
Items 28, 29 & 30) Signature and Date
WD - (No
Fee Required) Withdrawal of Application: To withdraw a previously filed, currently pending application(s).
Mandatory items required for submission of “WD” purpose are as follows:
Item 2) Application Purpose
Item 4) File Number (if filing for multiple File Numbers,
list additional File Numbers on Schedule A)
Item 9) FCC Registration Number (FRN)
Items 28, 29 & 30) Signature and Date
No fee is required for Governmental Entities. Send non-feeable packages to:
Federal Communications Commission
1270 Fairfield Road
Gettysburg, PA 17325-7245
Item 3 If the filing is a request for a Developmental License or a Special Temporary Authorization (STA), enter ‘D’ or ‘S’, respectively.
Otherwise, enter ‘N’ for Not Applicable.
Note:
Developmental Licenses are granted only to Ship and Aircraft Applicants/Licensees.
In emergencies or other urgent conditions requiring immediate or temporary use of facilities, request may be made for special
temporary authority (STA) to install and/or operate new or modified equipment, subject to the appropriate requirements governing
Special Temporary Authorizations contained in the FCC rules. If Item 3 is answered 'S’, attach an exhibit including the following
information: description of the nature of the extraordinary circumstance, equipment to be used, type of operation to be conducted,
explanation of how the facilities will be used, times and dates of operation, and a list of airports and/or ports that will be visited.
Note:
Special Temporary Authorizations are applicable only to Ship and Aircraft Applicants/Licensees.
FCC 605 - Instructions
May 2013 - Page 6
The FCC may grant applications for developmental authority to construct and operate transmitters for the purpose of developing a new
radio service or a new technology not regularly authorized under specific FCC rules, subject to the appropriate requirements governing
developmental authorizations contained in the FCC rules. Attach an exhibit(s) as required in the FCC rules.
Note: To file an initial request for an STA or Developmental License, Applicants/Licensees should select an application purpose of
NE - New in Item 2 and then answer Item 3 as appropriate. STAs are granted for a maximum of 180 days. If another STA is needed,
Applicants/Licensees may file by selecting application purpose of RM - Renewal/Modification and supply the appropriate Call Sign in
Item 5 or by selecting application purpose NE - New. The renewal/modification purpose is provided for the convenience of the
Applicant/Licensee (the Applicant/Licensee will retain the same call sign if the STA request is granted). To request a renewal of a
Developmental License, Applicants/Licensees should select an application purpose of RO – Renewal Only or RM Renewal/Modification and supply the appropriate Call Sign in Item 5.
Item 4 If the filing is a request for an Amendment or Withdrawal of a previously-filed currently pending application, provide the file
number of the original application. This information can be obtained by contacting the FCC at (877) 480-3201 (TTY 717-338-2824) or
If the amendment or withdrawal affects multiple file
by using Search Applications function available at http://wireless.fcc.gov/uls.
numbers, complete and attach Schedule for Changes Affecting Multiple Call Signs or File Numbers, Form FCC 605, Schedule A.
Item 5 If the filing is a request for a modification, renewal only, renewal/modification, cancellation, duplicate, or administrative update of
an existing license, enter the Call Sign (serial number for Commercial Operator) of the affected license in item 5. If the filing is a
request for a renewal only, cancellation or duplicate of an existing license(s), enter the Call Sign(s) (serial number for Commercial
Operator) of the affected license(s) in item 5. This information can be obtained by contacting the FCC at (877) 480-3201 (TTY 717338-2824) or by using the Search Licenses function available at http://wireless.fcc.gov/uls. If the request affects multiple call signs
(serial numbers for Commercial Operator), complete and attach Schedule for Changes Affecting Multiple Call Signs or File Numbers,
Form FCC 605, Schedule A. If filing a request to consolidate DO and DM operator classes, enter DO serial number in item 5.
Item 6 This item is optional. If the filing is a request for a New, Amendment, Renewal Only, or a Renewal/Modification, enter the
requested authorization expiration date. Applicants/Licensees may, if desired, request the month and day of license expiration.
However, in no cases will licenses be granted for terms that exceed the license term as governed by the rules for each service.
Item 7 If the filing is requesting a Waiver or Exception of the Commission's Rules, enter 'Y'; otherwise, enter 'N'. If item 7 is answered
'Y', attach an exhibit including a statement of reasons sufficient to justify a waiver. The required showing must be made for all rule
waivers desired, identifying the specific rules or policies for which the waiver is requested. Refer to the current Fee Filing Guide for fee
requirements for waivers. For assistance with fees applicable to the radio services governed by the FCC’s rules, call or (877) 480-3201
(TTY 717-338-2824).
Item 8 Enter ‘Y’ if attachments (other than associated schedules) are being filed with this application. Otherwise, enter ‘N’.
Applicant/Licensee Information
Items 9 through 23 identify the Applicant/Licensee. If an authorization is granted, the information provided will become the Licensee’s
name, address, and telephone number of record. The FCC will send the authorization and notice of all final dispositions of an
application to this address. Failure to provide the FCC with a current and valid mailing address in the United States (except for
Restricted Radiotelephone Operator Permits), and the subsequent failure to respond to FCC correspondence sent to the specified
address may result in dismissal of an application, and/or liability for forfeiture, or revocation of your authorization to operate a radio
station. Ship Exemptions must file under present Licensees information.
Item 9 FCC Registration Number (FRN) – This item must be completed. Enter your ten digit FRN assigned by the Commission
Registration System (CORES). The FRN is a unique entity identifier for everyone doing business with the Commission. The FRN can
be obtained electronically through the FCC webpage at http://wireless.fcc.gov/uls (click on CORES/CALL SIGN REGISTRATION) or by
manually submitting FCC Form 160. FCC Form 160 is available for downloading from http://www.fcc.gov/formpage.html, by calling the
FCC's Forms Distribution Center at (800) 418-3676, or from Federal Communications Commission Fax Information System by dialing
(202) 418-0177. Note: Licensees should then associate their WTB call sign(s) electronically at http://wireless.fcc.gov/uls (click on
CORES/CALL SIGN REGISTRATION) or by manually submitting FCC Form 606. FCC Form 606 can also be obtained from any of the
aforementioned locales as FCC Form 160.
Item 10 This item indicates the legal entity type of the Applicant. Select Individual, Corporation, Unincorporated Association, Trust,
Government Entity, Consortium, General Partnership, Limited Liability Company, Limited Liability Partnership, Limited Partnership, or
Other. When selecting ‘Other’, provide a description of the legal entity.
Note:
For GMRS: effective January 1, 1989, new or major modification applications may NOT be filed by non-individual
(business) Applicants/Licensees. (See Rule 1.929(c) (4) & 95.5(b).
Items 11 and 12 If Item 10 is ‘I’ (for Individual), you must enter the name of the individual person applying in Item 11. Otherwise, you
must enter the name of the entity in Item 12. If either Item 11 or 12 is being updated, you must answer Item 13.
Item 13 If the Licensee name is being updated, you must answer item 13. Check ‘N’ if the Licensee name is not the result from the sale
(or transfer of control) of the license(s) to another party. If checking ‘Y’, you must file for a new license.
FCC 605 - Instructions
May 2013 - Page 7
Items 14-21 Enter the name, address, and telephone number of the person to whom the FCC should send correspondence. All
Applicants/Licensees, except Applicants applying for a Restricted Radiotelephone Operator Permit, must specify an address where the
Applicant/Licensee can receive mail delivery by the United States Postal Service.
You may enter a post office box number in Item 15 or a street address in Item 16, or enter information for both items. Enter the City,
State, and Zip Code/Postal Code in Items 17, 18, and 19, respectively. Applicants for Restricted Radiotelephone Operator Permits who
do not have a United States mailing address must specify a Country in Item 20. Refer to FCC 605 Main Form Instructions, Appendix I,
for a list of valid state, jurisdiction, and area abbreviations. Enter a telephone number (optional), including area code, in Item 21.
Items 22 and 23 Enter the Applicant’s/Licensee’s fax number and email address, if desired and available.
Ship Applicants/Licensees Only
Item 24 For Administrative Update purposes only, enter the new name of the vessel.
Aircraft Applicants/Licensees Only
Item 25 Due to Federal Aviation Administration change, enter the new FAA Registration Number (the N-number).
NOTE: Do not enter the leading ‘N’.
Fee Status
Items 26-27 These items allow the Applicant/Licensee to apply for exemption from FCC application fees and regulatory fees. See the
current Fee Filing Guide, FCC Form 1070Y or call (877) 480-3201 (TTY 717-338-2824).
General Certification Statements
Certification Statements for GMRS Applicants/Licensees
Certification Statements for Ship Applicants/Licensees (Including Ship Exemptions)
Signature
Items 28-30 These items must be completed. To be acceptable for filing, applications and amendments must be signed in accordance
with Part 1 of the FCC rules. The signor must be a person authorized to sign the application. Paper originals of applications must
bear an original signature, neither rubber-stamped nor photocopied signatures are acceptable. Any application lacking an original
signature may be dismissed for non-compliance with FCC rules. Be sure all necessary attachments are included with the application.
The typed name of the person authorized to sign the application constitutes the legal signature for an electronically filed application.
FCC 605 - Instructions
May 2013 - Page 8
Appendix I
STATE TABLE
Abbreviations for States, Jurisdictions, and Areas
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GM
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Gulf of Mexico
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UM
UT
VT
VA
VI
WA
WV
WI
WY
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
U.S. Territories: (Baker Island, Howland Island, Jarvis
Island, Johston Atoll, Kingman Reef, Midway Island,
Navassa Island, Palmyra Atoll and Wake Island)
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming
Military:
AE Armed Forces Europe, the Middle East, Africa
and Canada
AP Armed Forces Pacific
AA Armed Forces Americas (except Canada)
FCC 605 - Instructions
May 2013 - Page 9
FCC 605
Main Form
Quick-Form Application for Authorization in the Ship, Aircraft,
Amateur, Restricted and Commercial Operator,
and General Mobile Radio Services
Approved by OMB
3060 - 0850
See instructions for
public burden estimate
1) Radio Service Code:
Application Purpose (Select only one) (
)
2) NE – New
RO – Renewal Only
WD – Withdrawal of Application
MD – Modification
RM – Renewal / Modification
DU – Duplicate License
AM – Amendment
CA – Cancellation of License
AU – Administrative Update
3) If this request is for Developmental License or STA (Special Temporary Authorization) enter the
(
) D S N/A
appropriate code and attach the required exhibit as described in the instructions. Otherwise enter ‘N’
(Not Applicable).
4)
5)
6)
If this request is for an Amendment or Withdrawal of Application, enter the file number of the pending
application currently on file with the FCC.
If this request is for a Modification, Renewal Only, Renewal / Modification, Cancellation of License,
Duplicate License, or Administrative Update, enter the call sign (serial number for Commercial
Operator) of the existing FCC license. If this is a request for consolidation of DO & DM Operator
Licenses, enter serial number of DO. Also, if filing for a ship exemption, you must provide call sign.
If this request is for a New, Amendment, Renewal Only, or Renewal Modification, enter the
requested expiration date of the authorization (this item is optional).
7)
Does this filing request a Waiver of the Commission’s Rules?
If ‘Y’, attach the required showing as described in the instructions.
8) Are attachments (other than associated schedules) being filed with this application?
File Number
Call Sign/Serial #
MM
DD
(
) Yes
No
(
) Yes No
Applicant/Licensee Information
9) FCC Registration Number (FRN):
10) Applicant/Licensee legal entity type: (Select One )
Individual
Corporation
Unincorporated Association
Trust
Government Entity
Consortium
General Partnership
Limited Liability Company
Limited Liability Partnership
Limited Partnership Other (Description of Legal Entity) ________________________________________________________________
11) First Name (if individual):
MI:
Last Name:
Suffix:
12) Entity Name (if other than individual):
13) If the Licensee name is being updated, is the update a result from the sale (or transfer of control) of the license(s) to another party
and for which proper Commission approval has not been received or proper notification not provided?
(
) Yes No
14) Attention To:
15) P.O. Box:
17) City:
21) Telephone Number:
And/Or
18) State:
16) Street Address:
19) Zip Code/Postal Code:
20) Country:
22) FAX Number:
23) E-Mail Address:
Ship Applicants/Licensees Only
24) Enter new name of vessel:___________________________
Aircraft Applicants/Licensees Only
25) Enter the new FAA Registration Number (the N-number):______________________________
NOTE: Do not enter the leading “N”.
FCC 605 – Main Form
May 2013 - Page 1
Fee Status
26) Is the Applicant/Licensee exempt from FCC application fees?
(
) Yes
No
27) Is the Applicant/Licensee exempt from FCC regulatory fees?
(
) Yes
No
General Certification Statements
1)
The Applicant/Licensee waives any claim to the use of any particular frequency or of the electromagnetic spectrum as against the
regulatory power of the United States because of the previous use of the same, whether by license or otherwise, and requests an
authorization in accordance with this application.
2)
The Applicant/Licensee certifies that all statements made in this application and in the exhibits, attachments, or documents
incorporated by reference are material, are part of this application, and are true, complete, correct, and made in good faith.
3)
Neither the Applicant/Licensee nor any member thereof is a foreign government or a representative thereof.
4)
The Applicant/Licensee certifies that neither the Applicant/Licensee nor any other party to the application is subject to a denial of
Federal benefits pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. § 862, because of a conviction for
possession or distribution of a controlled substance. This certification does not apply to applications filed in services
exempted under Section 1.2002(c) of the rules, 47 CFR § 1.2002(c). See Section 1.2002(b) of the rules, 47 CFR § 1.2002(b),
for the definition of “party to the application” as used in this certification.
5)
Amateur or GMRS Applicant/Licensee certifies that the construction of the station would NOT be an action which is likely to have a
significant environmental effect (see the Commission’s Rules 47 CFR Sections 1.1301-1.1319 and Section 97.13(a) rules
(available at web site http://wireless.fcc.gov/rules.html).
Amateur Applicant/Licensee certifies that they have READ and WILL COMPLY WITH Section 97.13(c) of the Commission’s Rules
(available at web site http://wireless.fcc.gov/rules.html) regarding RADIOFREQUENCY (RF) RADIATION SAFETY and the
amateur service section of OST/OET Bulletin Number 65 (available at web site http://www.fcc.gov/oet/info/documents/bulletins/).
6)
Certification Statements For GMRS Applicants/Licensees
1)
Applicant/Licensee certifies that he or she is claiming eligibility under Rule Section 95.5 of the Commission's Rules.
2)
Applicant/Licensee certifies that he or she is at least 18 years of age.
3)
Applicant/Licensee certifies that he or she will comply with the requirement that use of frequencies 462.650, 467.650, 462.700
and 467.700 MHz is not permitted near the Canadian border North of Line A and East of Line C. These frequencies are used
throughout Canada and harmful interference is anticipated.
4)
Non-Individual Applicants/Licensees certify that they have NOT changed frequency or channel pairs, type of emission, antenna
height, location of fixed transmitters, number of mobile units, area of mobile operation, or increase in power.
Certification Statements for Ship Applicants/Licensees (Including Ship Exemptions)
1) Applicant/Licensee certifies that they are the owner or operator of the vessel, a subsidiary communications corporation of the
owner or operator of the vessel, a state or local government subdivision, or an agency of the US Government subject to Section
301 of the Communications Act.
2) This application is filed with the understanding that any action by the Commission thereon shall be limited to the voyage(s)
described herein, and that apart from the provisions of the specific law from which the Applicant/Licensee requests an exemption,
the vessel is in full compliance with all applicable statues, international agreements and regulations.
Signature
28) Typed or Printed Name of Party Authorized to Sign
First Name:
MI:
Last Name:
Suffix:
29) Title:
Signature:
30) Date:
Failure to Sign This Application May Result in Dismissal Of The Application And Forfeiture Of Any Fees Paid
WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S.
Code, Title 18, Section 1001) AND / OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Title 47, Section
312(a)(1)), AND / OR FORFEITURE (U.S. Code, Title 47, Section 503).
FCC 605 – Main Form
May 2013 - Page 2
FCC 605
Schedule A
FEDERAL COMMUNICATIONS COMMISSION
Approved by OMB
3060 – 0850
See 601 Main Form Instructions
for public burden estimate
Information and Instructions
Schedule for Changes Affecting Multiple Call Signs
or File Numbers Form FCC 605
Schedule A
Instructions
Form FCC 605 Schedule A, is a supplementary schedule for use with the FCC Quick-Form Application for Authorization in the Ship,
Aircraft, Amateur, Restricted and Commercial Operator, and General Mobile Radio Services. Use this schedule when requesting
changes that affect multiple call signs, serial numbers or file numbers. Schedule A is not used with initial applications. Complete this
schedule to submit global changes to items on the FCC 605 Main Form that affect multiple call signs, multiple serial numbers or
multiple file numbers, depending on the Application Purpose entered for Item 2 of that form. Note the following:
Multiple File Numbers may be affected by these purposes: Amendment or Withdrawal of Application
Multiple Call Signs/Serial Numbers may be affected by these purposes: Modification, Renewal Only, Renewal/Modification,
Cancellation of License, Duplicate License, or Administrative Update
Each Schedule A or groups of Schedule A filed with the FCC 605 Main Form must use the same purpose, and only one purpose can be
specified per submission.
FCC 605 Schedule A - Instructions
May 2013 - Page 1
FCC 605
Schedule A
Schedule for Changes Affecting Multiple Call Signs
or File Numbers
Approved by OMB
3060 - 0850
See 605 Main Form
Instructions for public
burden estimate
Enter only multiple call signs, serial numbers, or file numbers for the following Form FCC 605 Main Form purposes:
Amendment or Withdrawal of Application (File Numbers)
Modification, Renewal Only, Renewal/Modification, Cancellation of License, Duplicate License, or Administrative Update (Call
Signs/Serial Numbers)
Note:
Form FCC 605 Main Form allows the selection of only one purpose per submission.
Each Schedule A or groups of Schedule A filed with the FCC 605 Main Form must use the same purpose.
Call Sign, Serial # or File #
Call Sign, Serial # or File #
Call Sign, Serial # or File #
Call Sign, Serial # or File #
FCC 605 - Schedule A
May 2013 - Page 1
FCC 605
Schedule B
FEDERAL COMMUNICATIONS COMMISSION
Approved by OMB
3060 - 0850
See 605 Main Form Instructions
Information and Instructions
for public burden estimate
Instructions for Schedule for Additional Data
for the Ship Radio Service (Part 80)
Form FCC 605, Schedule B, 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 supply information for Ship Radio Service (Part 80). The FCC 605 Main Form must be filed in conjunction with this schedule.
Schedule B
Instructions
You must obtain an FCC Ship Radio Station License if you answer ‘Y’ to any of the following questions. You must answer ‘Y’
or ‘N’ to each item.
Item 1 Enter ‘Y’ if you are required by law or treaty to carry a radio on your vessel. Otherwise, enter ‘N’.
Item 2 Enter ‘Y’ if your vessel travels to foreign ports. Otherwise, enter ‘N’.
Item 3 Enter ‘Y’ if you have marine radio equipment on board your vessel other than marine VHF radios, EPIRBs (Emergency Position
Indicating Radio Beacon), and radar. Otherwise, enter ‘N’.
NOTE: If you answered ‘N’ to Item 1, Item 2, and Item 3, you are not required to obtain a license
- you do not need to file this form with the FCC.
ADDITIONAL NOTE: If a ship license is not required, and you choose not to renew, the emergency information used to identify a ship
in distress will become inactive and not maintained by the FCC. Correct ship station information is vital for emergency purposes,
making it easier to identify and find boats in distress. If you were previously issued a Maritime Mobile Ship Identity (MMSI) by the FCC
for a DSC radio, you may update your ship station information with Boat U.S. free of charge using the FCC issued MMSI.
(http://www.boatus.com/mmsi/ ).
Type of License
Item 4 Enter the appropriate letter for the type of authorization desired.
Enter ’R’ if the type of license is regular (transmitter(s) to be used on 1 vessel only).
Enter ‘P’ if the type of license is portable (a single transmitter will be used on various U.S. registered vessels).
Enter ‘F’ if the type of license is fleet (several vessels will each have transmitters that operate in similar frequency
bands and are to be licensed under one authorization). If the type of license is a fleet, also enter the number of ships
in the fleet.
Class of Ship
Item 5
General Class of Ship - Enter the appropriate two letter code from the following list that describes the general class of ship:
MM………………………..……….Merchant
PL…………………………………..Pleasure
SV……………………………………Rescue
FV…………………………………….Fishing
GV…………………….Official Service Ship
FCC 605 Schedule B - Instructions
May 2013 - Page 1
Specific Class of Ship - Enter the appropriate two or three letter code from the following list that describes the specific class of ship:
ACV………………………..Air-cushion vehicle
AUX………………………………Auxiliary Ship
CHA……………………………………….Barge
BLK…………………………………Bulk Carrier
CBL…………………………………..Cable Ship
PMX…………………….Cargo and Passenger
CA………………………….………..Cargo Ship
CAB……………………….…………….Coaster
CON……………………….…….Container Ship
BTA………………………….……..Factory Ship
FBT………………………….………………Ferry
PH……………………………….Fishing Vessel
VDT…………………………………….Hydrofoil
MTB…………………………………...Motorboat
OIL……………………………………Oil Tanker
TPO………………………………….Ore Carrier
PA………………………………Passenger Ship
PLT…………………………………Pilot Tender
FRG………………………………………Reefer
EXP…………………Research or Survey Ship
VLR…………………………………Sailing Ship
RAM………………………………Salvage Ship
SLO………………………………………..Sloop
RAV……………………………..Supply Vessel
CIT……………………………………….Tanker
ECO………………………………Training Ship
TRA……………………………………….Tramp
CHR…………..…………………………Trawler
TUG……………..…………………………..Tug
BLN………………………………………Whaler
YAT………………………………………..Yacht
Other Required Information
Item 6 If applying for a new ship station authorization and the ship already has been assigned a four (4) letter call sign (e.g., WXYZ) by
the FCC, enter it here.
Item 7 Enter the name of the ship, if it has one. If it does not, it is suggested that you name your ship for identification purposes and
your own safety. If your ship is not named, and you have not provided a State Registration number in item 5, your application will be
returned.
Item 8 Enter the official Coast Guard Documentation Number (as it appears on the document, e.g., 250012) or the State Registration
Number (as it appears on the registration, e.g., FL2011GG) of the ship. Do not provide a foreign registration number since the FCC
does not license foreign registered vessels.
Item 9 Enter 'Y' if the ship will make international voyages. Otherwise, enter 'N'.
NOTE: Applications for a fleet station license, the vessels do not engage in voyages to any foreign country.
See 47 CFR § 80.55.
Item 10 Enter 'Y' if the ship will communicate with foreign coast stations. Otherwise, enter 'N'.
Radiotelegraph, Narrow-band Direct-printing (NB-DP)/SITOR, and Digital Selective Calling Equipment Information
Items 11-13 Complete only if you have Radiotelegraph, Narrow-band Direct-printing (NB-DP)/SITOR, or Digital Selective Calling
Equipment on board the vessel. Check each box that applies and provide the additional information as needed.
If you have been issued an MMSI number by COMSAT/Lockheed Martin or Stratos, enter in Item 13.
Note: If you have been issued an MMSI number by BoatUS, Maritel or SeaTow, these MMSI numbers are for vessels that do not
require an FCC license. DO NOT enter the MMSI number in Item 13. A new MMSI number will be issued by the Federal
Communications Commission.
FCC 605 Schedule B - Instructions
May 2013 - Page 2
Ship Radio Requirement Categories and Information
Items 14-15 Complete only if the vessel is required by law or treaty to carry radio equipment. Enter ‘Y’ or ‘N” for each requirement in
item 14. Enter the gross tonnage of the ship in item 15. If the ship is not documented or if the gross tonnage is not known, enter the
ship's length in meters in item 15.
(A) RADIOTELEGRAPH STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT is required on:
1) Cargo vessels 1600 and upward gross tons;
2) Vessels carrying more than 12 passengers, when leaving or attempting to leave U.S. harbor or port for a voyage in the open
sea.
Note: A vessel determined by the United States Coast Guard to have the equipment required to implement the
Global Maritime Distress and Safety System installed and operating in good working condition is not
required to be equipped with a radiotelegraph station.
(B) RADIOTELEPHONE STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT OR SAFETY
CONVENTION is required on cargo vessels 300 to 1600 gross tons.
Note: Passenger vessels and cargo vessels over 300 gross tons listed in category (A) and (B) are also subject to the
Safety Convention when navigated on international voyages, except on the Great Lakes.
(C) RADIOTELEPHONE STATION REQUIRED BY TITLE III, PART III OF THE COMMUNICATIONS ACT applies to any vessel
transporting MORE THAN SIX PASSENGERS FOR HIRE, to be navigated in the open sea or any tidewater adjacent or contiguous
to the open sea. This DOES NOT apply to vessels on the Great Lakes or to vessels subject to Title III, Part II.
(D) RADIOTELEPHONE STATION REQUIRED BY GREAT LAKES RADIO AGREEMENT:
1) Every vessel 20 meters or over;
2) Every vessel engaged in towing another vessel or floating object, except:
a) Where the maximum length of the towing vessel, measured from end to end over the deck exclusive
of sheer, is less than 8 meters and the length or breadth of the tow, exclusive of the towing line, is less
than 20 meters;
b) Where the vessel towed complies with subpart 80.951(b); or
c) Where the towing vessel and tow are located within a booming ground (an area in which logs are confined).
3) Any vessel carrying more than six passengers for hire.
(E) RADIOTELEPHONE STATION REQUIRED BY THE VESSEL BRIDGE-TO-BRIDGE RADIOTELEPHONE ACT applies to the
following:
1) Every power driven vessel of 20 meters or more in length;
2) Every vessel 100 gross tons and upwards carrying one or more passengers for hire;
3) Every towing vessel 7.8 meters or over;
4) Dredges or floating plants engaged in operations near a channel or fairway. An unmanned or intermittently manned floating
plant under the control of a dredge shall not be required to have a separate radiotelephone capability.
SEARCH AND RESCUE INFORMATION
Items 16 & 16a Complete name, address, telephone number, fax number and e-mail address of emergency contact person ashore and
alternative emergency contact person ashore. This information will not be made available for public inspection.
Item 17 Enter 406 MHz EPIRB identification code (15 digit number provided by EPIRB manufacturer).
Item 18 Chose the radio installation(s) for the ship and survival craft.
Item 19 Provide the exact quantity of each type of survival craft, raft and/or lifeboat. (A range is not acceptable)
Item 20 Enter the capacity of persons on board including passengers and crew.
FCC 605 Schedule B - Instructions
May 2013 - Page 3
FCC 605
Schedule B
Schedule for Additional Data for the
Ship Radio Service (Part 80)
Approved by OMB
3060 - 0850
See 605 Main Form Instructions
for public burden estimate
You must obtain an FCC Ship Radio Station License if you answer ‘Y’ to any of the following items and each item must be
completed with a ‘Y’ or ‘N’ response:
1) Are you required by law or treaty to carry a radio on your vessel?
(
) Yes
No
2) Does your vessel travel to foreign ports?
(
) Yes
No
3) Do you have marine radio equipment on board your vessel other than marine VHF radios, EPIRBs (Emergency Position
Indicating Radio Beacon), and radar?
(
) Yes No
If you answered ‘Y’ to any of these questions, you must obtain an FCC Ship Radio Station License, continue to complete
the form. If you answered ‘N’ to all of these questions, you do not need to file this form with the FCC.
4) Type of License: (
) Regular
Portable
Fleet If Fleet, give number of ships in fleet: _____________
5) Class of Ship: (enter one code for each) General Class of Ship: _____________Specific Class of Ship: _____________
6) If application is for a new authorization and the ship already has a four letter call sign, enter it here: _____________
Other Required Information
7) Name of ship:
8) Official Number of ship (Coast Guard Documentation No. or State Registration No.):
9) Will ship make international voyages? (Fleet Station applications must select ‘N’, see 47 CFR § 80.55.)
(
) Yes No
10) Will ship communicate with foreign coast stations?
(
) Yes No
Complete items 11-13 only if you have Radiotelegraph, Narrow-band Direct-printing (NB-DP)/SITOR, or Digital Selective
Calling Equipment. Check each box that applies and provide information as needed.
11) I have Radiotelegraph (2000-27500 KHz) on my vessel and the FCC has not yet assigned a Morse working series to my
vessel.
12) I have Digital Selective Calling (DSC) equipment and/or Radiotelegraph NB-DP and need a new 9 digit Maritime Mobile
Service Identity (MMSI). Do not check this box if you already have been assigned a 9 digit MMSI by the FCC or received
a 9 digit MMSI by commissioning an INMARSAT B, C, or M terminal through COMSAT/Lockheed Martin.
Note: The single MMSI assigned by the FCC or issued by COMSAT/Lockheed Martin or Stratos should be used with all
DSC radio equipment and INMARSAT B, C, or M terminals on board your vessel.
13) If already assigned, my MMSI Number is: ___________________________
Complete items 14 and 15 only if vessel is required by law or treaty to carry radio equipment.
14) Ship Radio Requirement Categories
(A) RADIOTELEGRAPH STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT
(B) RADIOTELEPHONE STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT OR
SAFETY CONVENTION
(C) RADIOTELEPHONE STATION REQUIRED BY TITLE III, PART III OF THE COMMUNICATIONS ACT
(
) Yes No
(
) Yes No
(
) Yes No
(
) Yes No
(
) Yes No
(D) RADIOTELEPHONE STATION REQUIRED BY GREAT LAKES RADIO AGREEMENT
(E) RADIOTELEPHONE STATION REQUIRED BY THE VESSEL BRIDGE-TO-BRIDGE RADIOTELEPHONE
ACT
FCC 605 - Schedule B
May 2013 - Page 1
15) Ship Information
Gross Tonnage:
Length (in meters):
SEARCH & RESCUE INFORMATION
16) EMERGENCY CONTACT PERSON ASHORE
MI:
First Name (if individual):
Last Name:
Suffix:
Street Address:
City:
State:
Telephone Number: (
)
Zip Code:
Country:
FAX Number: (
)
E-Mail Address:
16a) ALTERNATIVE EMERGENCY CONTACT PERSON ASHORE
MI:
First Name (if individual):
Last Name:
Suffix:
Street Address:
City:
State:
Telephone Number: (
)
Zip Code:
Country:
FAX Number: (
)
E-Mail Address:
17) 406 MHz EPIRB Identification Code: _________________________________________
(15 digit number provided by EPIRB manufacturer)
18) Radio Installation(s) for Ship and Survival Craft:
INMARSAT A
INMARSAT MINI M
DSC
INMARSAT B
VHF
406 MHz EPIRB
INMARSAT C
MF
121.5 MHz EPIRB
INMARSAT M
HF
SART
19) Quantity of Survival Craft(s):
Quantity of RAFT(S): _____________
Quantity of LIFEBOAT(S): _____________
20) Capacity of Persons on Board (including passengers and crew): _______________
FCC 605 - Schedule B
May 2013 - Page 2
FCC 605
Schedule C
FEDERAL COMMUNICATIONS COMMISSION
Approved by OMB
3060 - 0850
See 605 Main Form Instructions
Information and Instructions
for public burden estimate
Instructions for Schedule for Additional Data
for the Aircraft Radio Service (Part 87)
Form FCC 605, Schedule C, 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 supply information for authorizations in the Aircraft Radio Service (Part 87). The FCC 605 Main Form must be filed in
conjunction with this schedule.
You must obtain an FCC Aircraft Radio Station License if you make international flights or communicate with foreign stations.
If you are not required to obtain a license - you do not need to file this form with the FCC.
Schedule C
Instructions
Aircraft Making International Flights or Communications Information
Item 1 Enter ‘Y’ or ‘N’ if you will be making international flights or communicating with foreign stations. If ‘Y’, complete the form. If ‘N’, you are
not required to obtain a license – you do not need to file this form with the FCC.
Item 2 Enter the FAA Registration Number (the N-number). Leave blank if this is an initial application for Fleet or Portable license.
NOTE: Do not enter the leading ‘N’.
Item 3a If the application is for a Fleet license, enter 'Y'; otherwise, enter 'N'. (When entering ‘Y’, Item 1, FAA Registration Number
should be blank)
Item 3b Enter the total number of aircraft in the Fleet if item 2a is answered 'Y'.
Item 4 If the application is for a Portable (a single transmitter will be used on various U.S. registered aircraft) license, enter 'Y';
otherwise, enter 'N'. (When entering ‘Y’, Item 1, FAA Registration Number should be blank)
Item 5 If the application is for a Private Aircraft, enter 'P'. Otherwise, enter 'A' for Air Carrier.
FCC 605 Schedule C – Instructions
May 2013 – Page 1
FCC 605
Schedule C
Schedule for Additional Data for the
Aircraft Radio Service (Part 87)
Approved by OMB
3060 - 0850
See 605 Main Form Instructions
for public burden estimate
1) Will you be making international flights or communicating with foreign stations? (
) Yes No
If ‘Y’, complete the form. If ‘N’, you are not required to obtain a license – you do not need to file this form with the FCC.
2) Provide the FAA Registration Number (N-number): N________________________________________
3a) Is this application for a Fleet License?
(
4) Is application for a portable license? (
) Yes No
5) Select Classification (Enter only one):
(
) Yes No
) Private Aircraft
3b) Total number of aircraft in fleet?
Air Carrier
FCC 605 - Schedule C
May 2013 – Page 1
FCC 605
Schedule D
FEDERAL COMMUNICATIONS COMMISSION
Approved by OMB
3060 - 0850
See 605 Main Form Instructions
Information and Instructions
for public burden estimate
Instructions for Schedule for Additional Data
in the Amateur Radio Service
Form FCC 605, Schedule D, 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 in the Amateur Radio Service. This schedule is used to apply for a call sign change
or to apply for a vanity call sign. The FCC 605 Main Form must be filed in conjunction with this schedule.
Schedule D
Instructions
Amateur Station Call Sign Change and Vanity Call Sign Request Information
Item 1 If this is a request to change your call sign to the next systematically assigned call sign you are eligible for, enter ‘Y’. This will
result in your call sign being selected by the FCC from an alphabetized list corresponding to the geographic region of your mailing
address and operator class. If this is to request a Vanity call sign, enter ‘N’. If this is a Modification or Renew/Modification application
with NO change in call sign requested, enter ‘N’ and skip Items 2 and 3.
Item 2 If this is a request to apply for a vanity call sign, place an 'X' in the appropriate box and enter the additional information
requested. (Only one block may be checked)
Item 3 Preference List: Give the exact prefix, numeral and suffix of each call sign that you wish to include in your preference list for
vanity call sign assignment. NOTE: If none of the call signs that you request are assignable, you will retain your existing call sign.
FCC 605 Schedule D - Instructions
May 2013 - Page 1
FCC 605
Schedule D
Schedule for Additional Data in the
Amateur Radio Service
Approved by OMB
3060 - 0850
See 605 Main Form Instructions
for public burden estimate
AMATEUR STATION CALL SIGN CHANGE AND VANITY CALL SIGN REQUEST
Systematic Call Sign Change
1) Is this a request to change your station call sign to the next systematically available call sign?
(
)
Yes No
If you answered Yes (‘Y’) to Item 1, do not complete Items 2 and 3 on this schedule. If completing Item 2, Item 1 must be answered No (‘N’).
Vanity Call Sign Change
2) I hereby apply for a vanity call sign under the following eligibility: (make an ‘X’ in the appropriate box and enter the required information):
(Only 1 block may be checked)
A)
FORMER PRIMARY STATION HOLDER: I request call sign _______________ be shown on my primary station license. By checking
this box, I certify that the call sign being requested was previously assigned to my station and that I can provide documentation, if
requested.
B)
CLOSE RELATIVE OF FORMER HOLDER: I request call sign _______________ be shown on my primary station license. By
checking this box, I certify that the call sign being requested was shown on the primary station license of my deceased spouse, child,
grandchild, stepchild, parent, grandparent, stepparent, brother, sister, stepbrother, stepsister, aunt, uncle, niece, nephew, or in-law
within the past 2 years and that I can provide documentation, if requested.
Enter the deceased relationship to you: ____________________________________.
C)
FORMER CLUB STATION HOLDER: I request call sign _______________ be shown on the license for the club station, for which I
am the license trustee. By checking this box, I certify that the call sign being requested was shown on the license for this club station
within the past 2 years and that I can provide documentation, if requested.
D)
CLUB STATION WITH CONSENT OF FORMER HOLDER OR CLOSE RELATIVE OF FORMER HOLDER: I request that the call sign
_______________ be shown on the license for the club station, for which I am the license trustee. By checking this box, I certify that
the call sign being requested was shown on the primary station license of a person now deceased within the past 2 years. I also
certify that I am acting with written consent of the former holder now deceased or of the deceased former holder's spouse, child,
grandchild, stepchild, parent, grandparent, stepparent, brother, sister, stepbrother, stepsister, aunt, uncle, niece, nephew, or in-law,
and I can provide documentation of that consent, if requested.
E)
F)
Enter "self" if deceased licensee gave consent or the relationship of the person giving consent:
____________________________________________.
PRIMARY STATION PREFERENCE LIST: I request the first assignable call sign from my preference list in item #3 be shown on the
license for my primary station.
CLUB STATION PREFERENCE LIST: I request the first assignable call sign from my preference list in item #3 be shown on the
license for the club station, for which I am the license trustee.
Vanity Call Sign PREFERENCE LIST
3) Select your preference list of vanity call signs very carefully. Give exact prefix, numeral, and suffix for each call sign.
1)
6)
11)
16)
21)
2)
7)
12)
17)
22)
3)
8)
13)
18)
23)
4)
9)
14)
19)
24)
5)
10)
15)
20)
25)
Note: If none of the call signs you selected are assignable, you will retain your existing call sign.
FCC 605 - Schedule D
May 2013 - Page 1
FCC 605
Schedule E
FEDERAL COMMUNICATIONS COMMISSION
Approved by OMB
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
| File Type | application/pdf |
| File Title | 605 Main 2013.05.pdf |
| Author | user01 |
| File Modified | 2013-05-08 |
| File Created | 2013-05-08 |