Form FCC 605 Main FCC 605 Main Quick-Form Application for Authorization in the Ship, Ai

FCC 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,.
Applicants should link their FRN to their FCC Username Account at https://apps.fcc.gov/cores/userLogin.do.
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 Main Form - Instructions
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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.

Schedules Required

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.

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 for the Commercial Radio, Restricted Radiotelephone,
and Restricted Radiotelephone-Limited Use Radio Services
Main Form 605 - Quick-Form Application for Authorization

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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, For assistance with fees applicable to the radio services governed by the FCC’s rules, call (877) 480-3201
A S L V i d e o p h o n e : 1 - 8 4 4 - 4 3 2 - 2 2 7 5 . If you are required to submit payment with your application, it is
recommended that you pay electronically. Manual paym ents must be accom panied by an FCC Form 159 (Fee
Remittance Advice). The Fee Filing Guide, a n d FCC Form 159 and a r e a v a i l a b l e a t from the FCC’s web
site at http://www.fcc.gov/formpage.html,
A l l applications a r e r e q u i r e d t o b e f i l e d e l e c t r o n i c a l l y u s i n g t h e U n i v e r s a l L i c e n s i n g S y s t e m
( U L S ) . A p p l i c a t i o n s requiring a fee may be paid electronically during the application process or
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.Payments mailed to U.S. Bank must be include an
FCC Form 159. Electronic payment of application fees is recommended.
Information on electronic filing is provided on Page 4 of these instructions.
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, ASL Videophone: 1-844-432-2275, or visit the web at http://esupport.fcc.gov.

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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 717-3382824), 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
9050 Junction Drive
Annapolis Junction, MD 207011150
Attention: TSI Division
.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).

How to Obtain an Official Authorization
Please Note: Upon grant of this application, the new or modified official authorization will be available electronically to the licensee
through License Manager. All licensees have electronic access to download, save and print their official authorizations, to the extent
needed, when securely logged into License Manager.
A licensee will obtain an electronic version of their authorization through email once the application is granted. The electronic
authorization will be sent to the a valid email address in the application filed through Official authorizations will be emailed to the
licensee, not to the contact listed on the application. The Commission will not distribute official authorizations on paper by mail.

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

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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 unless you are requesting a Transfer of Control or Assignment of Authorization of a
vessel or aircraft license, in which case you must file FCC Form 603. 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.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. With the exception of a vanity call sign request in the Amateur Radio
Service, 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.
Simple Application Purpose & Requirements 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)
Item 23) Email Address
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.
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.

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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)
Item 23) E-Mail Address
Items 29, 30 & 31) 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.
Item 3 If the filing is a request for a Special Temporary Authorization (STA), enter ‘Y. Otherwise, enter ‘N’.
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 'Y’, 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. To file an initial
request for an STA, 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).

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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, ASL Videophone: 1-844432-2275 or by using Search Applications function available at http://wireless.fcc.gov/uls. If the amendment or withdrawal affects
multiple file 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, 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, or cancellation 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,
ASL Videophone: 1-844-432-2275. 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
ASL Videophone: 1-844-432-2275.
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, telephone number and e-mail of record. Please Note: Upon grant of this application, the FCC will send the authorization
electronically to the License’s email address of record. The new or modified official authorization also will be available electronically to the
licensee through License Manager. All licensees have electronic access to download, save and print their official authorizations, when
securely logged into License Manager. Failure to provide the FCC with a current and valid e mail address (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 Applicants should
link their FRN to their FCC Username Account at https://apps.fcc.gov/cores/userLogin.do.
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 nonindividual (business) Applicants/Licensees. (See Rule 1.929(c) (4) & 95.1705(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.
Items 14-21 Enter the name, address, e - m a i l a d d r e s s , 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 a valid e-mail address where the Applicant/Licensee can receive e-mail delivery.
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,

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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.
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, ASL Videophone: 1-844-432-2275
Basic Qualifications
Item 28 This item enables the FCC to determine whether an Applicant is eligible under §§ 310(d) and 308(b) of the Communications
Act of 1934, as amended, to hold or have ownership interest in a station license. Applicants are required to answer this questions only
if 1) they are filing FCC Form 605 for one of the following purposes indicated in Item 2: New, Amendment, Modification, Renewal Only
or Renewal/Modification; and 2) the answers have changed from those previously provided. Applicants using FCC Form 605 for any
other purpose are not required to answer this question. If the answer to item 28 ‘Y’, attach as an exhibit a statement explaining the
circumstances and a statement giving the reasons why the Applicant believes that grant of the application would be in the public
interest notwithstanding the actual or alleged misconduct. If the Applicant responds ‘Y’ to this question and has previously provided a
statement and explanation regarding the circumstances as an attachment to a prior application filed in ULS, and the facts and
circumstances are unchanged, the Applicant may refer to the previous application by identifying the application file number and
indicating the disposition of the prior application.
General Certification Statements
Certification Statements for GMRS Applicants/Licensees
Certification Statements for Ship Applicants/Licensees (Including Ship Exemptions)
Signature
Items 29-31 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.
The typed name of the person authorized to sign the application constitutes the legal signature for an electronically filed application.

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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
MO
MS

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
Missouri
Mississippi

MT
NE
NV
NH

Montana
Nebraska
Nevada
New Hampshire

NJ
NM
NY
NC
ND
MP
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UM

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, Johnston Atoll, Kingman Reef, Midway Island,
Navassa Island, Palmyra Atoll and Wake Island)
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming

UT
VT
VA
VI
WA
WV
WI
WY

Military:
AE
Armed Forces Europe, the
Middle East, Africa and
Canada
AP
Armed Forces Pacific
AA
Armed Forces Americas (except Canada)

FCC 605 Main Form - Instructions
Ju ly 20 21 - Page 9

FCC 605
Main Form

Qu ick-Form Application for Authorization in the Ship, Aircraft,
Amateur, Restricted and Commercial Operator,
and General Mobile Radio Services

1) Radio Service Code:

Application Purpose (Select only one) (

Approved by OMB
3060 - 0850
See instructions for
public burden estimate

)

2) NE – New
RO – Renewal Only
WD – Withdrawal of Application
MD – Modification
RM – Renewal / Modification
AM – Amendment
CA – Cancellation of License
AU – Administrative Update
3) Does this filing request STA (Special Temporary Authorization)? If ‘Y’, attach the required exhibit as
(
) Yes No
described in the instructions.
4)

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.
5) If this request is for a Modification, Renewal Only, Renewal / Modification, Cancellation of 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.
6) 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
Consortium
General Partnership
Limited Liability Company
Limited Partnership
Other (Description of Legal Entity)
11) First Name (if individual):

MI:

Trust
Government Entity
Limited Liability Partnership

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:

And/Or

17) City:
21) Telephone Number:

18) State:

16) Street Address:

19) Zip Code/Postal Code:
22) FAX Number:

20) Country:

23) E-Mail Address:

FCC 605 - Main Form
J u l y 2 0 2 1 - Page 1

Ship Applicants/Licenses 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”.

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

(

) Yes No

Basic Qualifications
28) Has the Applicant or any party to this application, or any party directly or indirectly controlling the Applicant,
ever been convicted of a felony by any state or federal court?
If the answer is ‘Y’, attach an exhibit explaining the circumstances.
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).
6) 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/).

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)

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.

FCC 605 - Main Form
J u l y 2 0 2 1 - Page 2

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
29) Typed or Printed Name of Party Authorized to Sign
First Name:

MI:

Last Name:

Suffix:

30) Title:
Signature:

31) 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
J u l y 2 0 2 1 - Page 3

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, Cancellation of
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
September 2017 - Page 1

FCC 605
Schedule A

Schedule for Changes Affecting Multiple Call Signs
or File Numbers

Approved by OMB
3060 - 0850
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
September 2017 - 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 vessel in distress. Vessels requiring an MMSI that do not require an FCC license should register their vessel with
a private registration agent - https://www.fcc.gov/wireless/bureau-divisions/mobility-division/maritime-mobile/ship-radio-stations/maritime-mobile.
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). NOTE If
this request is for a portable VHF handheld, please refer to Public Notice DA 22-1065 for additional instructions.
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. NOTE: Fleet authorizations are not assigned MMSIs. If the vessel(s) has DSC or AIS equipment then an
individual ship station license is required. If you proceed with a fleet license request, please provide an attachment
confirming that the vessels in the fleet do not require an MMSI for DSC or AIS equipment.
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
September 2017 - 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.
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
September 2017 - 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 for both:
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
September 2017 - 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
September 2017 - Page 1

15) Ship Information
Gross Tonnage:

Length (in meters):

SEARCH & RESCUE INFORMATION
16) EMERGENCY CONTACT PERSON ASHORE
First Name (if individual):

MI:

Last Name:

Suffix:

Street Address:
City:

State:

Telephone Number: (

)

Zip Code:
FAX Number: (

Country:
)

E-Mail Address:

16a) ALTERNATIVE EMERGENCY CONTACT PERSON ASHORE
First Name (if individual):

MI:

Last Name:

Suffix:

Street Address:
City:

State:

Telephone Number: (

)

Zip Code:
FAX Number: (

Country:
)

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
September 2017 - Page 2