FCC 605 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB
Schedule D 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 Item 2.
Item 2 If this is a request to apply for a vanity call sign, you must place an 'X' in the appropriate box and provide the additional information requested. (Only one block may be checked)
If you checked box A or B, you must complete the 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.
If you checked box C or D, be advised that an ‘in-law’ is defined as: parent, stepparent, sibling, or step-sibling of a licensee’s spouse; and the spouse of a licensee’s sibling, step-sibling, child or stepchild; or the spouse of a licensee’s spouse’s sibling or step-sibling
Note: Only check box C, D, E or F if less than 2 years has passed since the expiration or cancellation of the prior license for that call sign. Otherwise, check box A or B.
FCC 605 Schedule D - Instructions
Edition Date – Page 1
FCC 605 Schedule for Additional Data in the Approved by OMB
Schedule D Amateur Radio Service 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 Item 2 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 for A through F) |
|
A |
PRIMARY STATION PREFERENCE LIST: I request the first assignable call sign from my Preference List be shown on the license for my primary station. |
|
B |
CLUB STATION PREFERENCE LIST: I request the first assignable call sign from my Preference List be shown on the license for the club station, for which I am the license trustee |
PREFERENCE LIST FOR A VANITY CALL SIGN (complete this section only if you placed an ‘X’ in the box above for A or B)
Select your preference list of vanity call signs very carefully. Give exact prefix, numeral, and suffix for each call sign. If none of the call signs you selected are assignable, you will retain your existing call sign.
1)
|
6) |
11) |
16) |
21) |
2)
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7) |
12) |
17) |
22) |
3)
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8) |
13) |
18) |
23) |
4)
|
9) |
14) |
19) |
24) |
5)
|
10) |
15) |
20) |
25) |
|
C |
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 and that I can provide documentation, if requested.
Circle the deceased licensee’s relationship to you. |
|
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 who was a member of the club. 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.
Circle the relationship of the person giving consent or enter "self" if deceased licensee gave consent: ________________________
|
|
E |
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. |
|
F |
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 and that I can provide documentation, if requested.
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FCC 605 Schedule D
Edition Date – Page 1
| File Type | application/msword |
| File Title | FCC 605 |
| Author | user01 |
| Last Modified By | judith |
| File Modified | 2011-05-04 |
| File Created | 2011-05-04 |