FCC Form 605, Sche Instructions for Schedule for Exemption from Ship Statio

FCC 605 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB

Schedule G 3060 - 0850

See 605 Main Form Instructions

Information and Instructions for public burden estimate

Instructions for Schedule for

Exemption From Ship Station Requirements (Part 80)

Form FCC 605, Schedule G, 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 Exemption from Ship Station Requirements in the Ship Radio Service (Part 80.59c). The FCC 605 Main Form must be filed in conjunction with this schedule.

Application for exemption from the radio provisions of part II or III of Title III of the Communications Act, the Safety Convention, or the Great Lakes Radio Agreement, must be filed as a waiver request using FCC 605 Schedule G. Failure to fully answer questions contained in this application may delay the processing of your application.

NOTE: THE PURPOSE ON THE FCC 605 MAIN FORM ITEM 2 MUST BE FILED AS NEW.

Schedule G

Instructions

Item 1 Enter the name of the port of which the vessel is registered.

Item 2 Provide the file number of exemption letter on previously granted exemption. Otherwise, leave blank.

Item 3 Select the appropriate blocks(s) that indicates type of applicant/licensee.

Item 4a Select the appropriate block describing the type of vessel.

Item 4b Provide the number of crew, number of passengers and number of others the vessel will carry.

Attach a copy of USCG Certificate of Inspection.

Item 5 Select the appropriate block(s) for exemption requirement.

Item 6 Select ‘Y’ if the vessel will travel to a foreign port. Otherwise, enter ‘N’.

Item 7 Select reasons for exemption request. You may select more than one reason.

Item 8 Provide the quantity of each type of radio equipment being carried on board. For Single Side-Band, choose type.

Item 9 Describe the voyage(s) for which applicant/licensee is requesting exemption. The description must include the maximum distance from the nearest land in nautical miles; the maximum distance between two consecutive ports in nautical miles; and the names of all ports of call and an indication of whether travel will include a foreign port.

FCC 605 Schedule G – Instructions

Edition Date – Page 1

FCC 605 Schedule for Exemption from Ship Station Approved by OMB

Schedule G Requirements in the Ship Radio Service (Part 80) 3060 - 0850

See 605 Main Form Instructions

for public burden estimate

1) Port of Registry:

2) If vessel has been granted an exemption previously, list the file number that appears on the upper right hand corner of the

exemption letter. File Number of any previously granted exemption: _____________________

3

) Applicant/Licensee is: Owner Operator Charter Agent of above ship

4a) Vessel is certified by the U.S. Coast Guard as a:

Passenger Cargo vessel

4b) The vessel will carry: Number of Crew ________, Number of Passengers ________, and Number of Others _______.

Attach a copy of the U. S. Coast Guard (USCG) Certificate of Inspection

5) Requirement from which you request exemption:

Radiotelephone (VHF/MF) GMDSS Radio Direction Finding Apparatus

6

) Will vessel travel to a foreign port while navigating the voyages for which exemption is required? Yes No

7. Reason(s) for exemption request for the voyages described herein:

Size of Vessel Variety of Equipment on Board Limited Routes Conditions of Voyages

Other (Explain):______________________________________________________________________________

7. Provide the quantity of radio equipment being carried on board the vessel:

_____ VHF Radio Installation ( ) DSC

_____ Single Side-Band (SSB – Band of Operations) Chose Type: ( ) MF ( ) HF ( ) DSC

_____ Category 1,406 EPIRB (GMDSS approved) _____ NAVTEX Receiver (GMDSS approved)

_____ Survival Craft VHF (GMDSS approved) _____ 9 GHz Radar Transponder (GMDSS approved)

_____ Ship Earth Station _____ 500 KHz Distress Frequency Watch Receiver

_____ 2182 Radiotelephone Auto Alarm _____ Reserve Power Supply (Capability)

_____ Other Equipment (Specify)________________________________

7. Describe in detail the voyages(s) for which the applicant/licensee requests an exemption, including, in nautical miles, both the maximum distance from the nearest land and the maximum distance between two consecutive ports as well as the names of all ports of call. (Note: Applicant/Licensee may also submit a nautical chart with application.)

FCC 605 - Schedule G

Edition Date – Page 1