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

FCC 605	FEDERAL COMMUNICATIONS COMMISSION	Not Approved by OMB
Main Form		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 (3060- 0850). 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. 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.

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.

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	ULS Form/Schedule Title
Ship Radio Service (47 CFR Part 80) Waiver request for Exemption from Ship Station Requirements	Main Form 605 - Quick-Form Application for Authorization Schedule B - Schedule for Additional Data for the Ship Radio Service Main Form 605 - Quick-Form Application for Authorization Schedule G – Exemption from Ship Station Requirements
Aircraft Radio Service (47 CFR Part 87)	Main Form 605 - Quick-Form Application for Authorization Schedule C - Schedule for Additional Data for the Aircraft Radio Service
Amateur Radio Service (47 CFR Part 97)	Main Form 605 - Quick-Form Application for Authorization Schedule D - Schedule for Additional Data in the Amateur Radio Service
Commercial Radio Operator, Restricted Radiotelephone, and Restricted Radiotelephone- Limited Use Radio Services (47 CFR Part 13)	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
General Mobile Radio Service [GMRS] (47 CFR Part 95)	Main Form 605 - Quick-Form Application for Authorization

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. To determine the required fee amount, refer to Subpart G of Part 1 of the Code of Federal Regulations (47 CFR Part 1, Subpart G), or the current Fee Filing Guide. 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.The Fee Filing Guide can be downloaded from WTB’s web page https://www.fcc.gov/wireless-fees.

All applications are required to be filed electronically using the Universal Licensing System (ULS). Applications requiring a fee must be paid electronically, payment must be received within ten days of the application receipt date...

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.

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 link to pay electronically through the COmmission REgistration System (CORES). 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 20701- 1150

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

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.

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).

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: 1-844- 432-2275 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 non- individual (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,

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, 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.

Appendix I STATE TABLE

Abbreviations for States, Jurisdictions, and Areas

AL	Alabama	NJ	New Jersey
AK	Alaska	NM	New Mexico
AS	American Samoa	NY	New York
AZ	Arizona	NC	North Carolina
AR	Arkansas	ND	North Dakota
CA	California	MP	Northern Mariana Islands
CO	Colorado	OH	Ohio
CT	Connecticut	OK	Oklahoma
DE	Delaware	OR	Oregon
DC	District of Columbia	PA	Pennsylvania
FL	Florida	PR	Puerto Rico
GA	Georgia	RI	Rhode Island
GM	Gulf of Mexico	SC	South Carolina
GU	Guam	SD	South Dakota
HI	Hawaii	TN	Tennessee
ID	Idaho	TX	Texas
IL	Illinois	UM	U.S. Territories: (Baker Island, Howland Island, Jarvis
IN	Indiana		Island, Johnston Atoll, Kingman Reef, Midway Island,
IA	Iowa		Navassa Island, Palmyra Atoll and Wake Island)
KS	Kansas	UT	Utah
KY	Kentucky	VT	Vermont
LA	Louisiana	VA	Virginia
ME	Maine	VI	Virgin Islands
MD	Maryland	WA	Washington
MA	Massachusetts	WV	West Virginia
MI	Michigan	WI	Wisconsin
MN	Minnesota	WY	Wyoming
MO	Missouri
MS	Mississippi

MT Montana

NE Nebraska

NV Nevada

NH New Hampshire

Military:

AE Armed Forces Europe, the Middle East, Africa and Canada

AP Armed Forces Pacific

AA Armed Forces Americas (except Canada)

FCC 605 Qu	ick-Form Application for Authorization in the Ship, Aircraft,	Approved by OMB
Main Form	Amateur, Restricted and Commercial Operator,	3060 - 0850
	and General Mobile Radio Services	See instructions for
		public burden estimate

1) Radio Service Code:

Application Purpose (Select only one) ( )

2) NE – New MD – Modification CA – Cancellation of License	RO – Renewal Only RM – Renewal / Modification AU – Administrative Update	WD – Withdrawal of Application AM – Amendment
3) Does this filing request STA (Special Temporary Authorization)? If ‘Y’, attach the required exhibit as described in the instructions.			( ) Yes No
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.			File Number
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.			Call Sign/Serial #
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).			MM	DD
7) Does this filing request a Waiver of the Commission’s Rules? If ‘Y’, attach the required showing as described in the instructions.			( ) Yes No
8) Are attachments (other than associated schedules) being filed with this application?			( ) 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:	And/Or		16) Street Address:
17) City:	18) State:		19) Zip Code/Postal Code:		20) Country:
21) Telephone Number:			22) FAX Number:
23) E-Mail Address:

Ship Applicants/Licenses Only

25) Enter the new FAA Registration Number (the N-number):

NOTE: Do not enter the leading “N”.

Aircraft Applicants/Licensees Only

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

Basic Qualifications

28) Has the Applicant or any party to this application, or any party directly or indirectly controlling the Applicant, ( ) Yes No 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.

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

Schedule A

FEDERAL COMMUNICATIONS COMMISSION

Information and Instructions

Schedule for Changes Affecting Multiple Call Signs or File Numbers Form FCC 605

Schedule A Instructions

Approved by OMB

3060 – 0850

See 601 Main Form Instructions for public burden estimate

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

FCC 605 Schedule A	Schedule for Changes Affecting Multiple Call Signs or File Numbers	Approved by OMB 3060 - 0850
		05 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

^{FCC 605 FEDERAL COMMUNICATIONS COMMISSION} Approved by OMB

Schedule B

Information and Instructions

3060 - 0850

See 605 Main Form 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

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.

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.

1. 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.

2. 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.

3. 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.

4. RADIOTELEPHONE STATION REQUIRED ON THE GREAT LAKES BY SUBPART T OF PART 80:

1. Every vessel 20 meters or over;

2. Every vessel engaged in towing another vessel or floating object, except:

1. 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;

2. Where the vessel towed complies with subpart 80.951(b); or

3. 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.

5. 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 for Additional Data for the} Approved by OMB

^{Schedule B Ship Radio Service (Part 80)} 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	( ) Yes No
    (B) RADIOTELEPHONE STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT OR SAFETY CONVENTION	( ) Yes No
    (C) RADIOTELEPHONE STATION REQUIRED BY TITLE III, PART III OF THE COMMUNICATIONS ACT	( ) Yes No
    (D) RADIOTELEPHONE STATION REQUIRED ON THE GREAT LAKES BY SUBPART T OF PART 80	( ) Yes No
    (E) RADIOTELEPHONE STATION REQUIRED BY THE VESSEL BRIDGE-TO-BRIDGE RADIOTELEPHONE ACT	( ) Yes No

15. Ship Information

SEARCH & RESCUE INFORMATION

14. EMERGENCY CONTACT PERSON ASHORE

First Name (if individual):		MI:	Last Name:	Suffix:
Street Address:
City:	State:		Zip Code:		Country:
Telephone Number: ( )			FAX Number: ( )
E-Mail Address:

16a) ALTERNATIVE EMERGENCY CONTACT PERSON ASHORE

First Name (if individual):		MI:	Last Name:	Suffix:
Street Address:
City:	State:		Zip Code:		Country:
Telephone Number: ( )			FAX Number: ( )
E-Mail Address:

14. 406 MHz EPIRB Identification Code:

(15 digit number provided by EPIRB manufacturer)

14. Radio Installation(s) for Ship and Survival Craft:

INMARSAT A

INMARSAT MINI M

DSC

INMARSAT B

VHF

406 MHz EPIRB

INMARSAT C MF

INMARSAT M HF

121.5 MHz EPIRB SART

14. Quantity of Survival Craft(s): Quantity of RAFT(S): Quantity of LIFEBOAT(S):

14. Capacity of Persons on Board (including passengers and crew):

FCC 605 - Schedule B December 2023 - Page 2

FCC 605	FEDERAL COMMUNICATIONS COMMISSION	Approved by OMB
Schedule C	Information and Instructions	3060 - 0850 See 605 Main Form 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 for Additional Data for the	Approved by OMB
Schedule C	Aircraft Radio Service (Part 87)	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?	( ) Yes No		3b) Total number of aircraft in fleet?
4) Is application for a portable license? (	) Yes No
5) Select Classification (Enter only one):	( ) Private Aircraft	Air Carrier

FCC 605	FEDERAL COMMUNICATIONS COMMISSION Approved by OMB
Schedule D		3060 - 0850 See 605 Main Form Instructions for public burden estimate
	Information and Instructions

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 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 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. Enter "self" if deceased licensee gave consent or the relationship of the person giving consent: .
E)	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.
F)	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.

Schedule E

Information and Instructions

3060 - 0850 See 605 Main Form Instructions for public burden estimate

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

Restricted Radiotelephone-Limited Use Radio Services

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

Schedule E Instructions

License Type/Endorsements Information

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

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

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

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

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

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

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

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

FCC 605	Schedule for Additional Data for the Commercial Radio,	Approved by OMB
Schedule E	Restricted Radiotelephone, and	3060 - 0850
	Restricted Radiotelephone-Limited Use Radio Services	See 605 Main Form Instructions for public burden estimate

LICENSE TYPE / ENDORSEMENTS INFORMATION

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

	General Radiotelephone Operator License (PG)		Radiotelegraph Operator License (T)
	GMDSS Radio Operator's License (DO)		First Class Radiotelegraph Operator's Certificate (T1)
	GMDSS Radio Maintainer's License (DM)		Second Class Radiotelegraph Operator's Certificate (T2)
	GMDSS Radio Operator/ Maintainer License (DB)		Third Class Radiotelegraph Operator's Certificate (T3)
	GMDSS Restricted Radio Operator License (RG)		Restricted Radiotelephone Operator Permit (RR)
	Marine Radio Operator Permit (MP)		Restricted Radiotelephone Operator Permit-Limited Use (RL)

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

2. Endorsement Type (Check endorsements that apply)

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

3. Certification Category

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

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

	CERTIFICATION FOR LICENSES AND ENDORSEMENTS OTHER THAN RESTRICTED RADIOTELEPHONE
I certify that: I can speak and hear.

OR

CERTIFICATION FOR RESTRICTED RADIOTELEPHONE OPERATOR PERMIT

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

OR

CERTIFICATION FOR RESTRICTED RADIOTELEPHONE OPERATOR PERMIT-LIMITED USE

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

FCC 605	FEDERAL COMMUNICATIONS COMMISSION	Approved by OMB
Schedule F	Information and Instructions	3060 - 0850 See 605 Main Form Instructions for public burden estimate

Instructions for Temporary Operator Permit for the Ship, Aircraft, Restricted Radiotelephone,

Restricted Radiotelephone-Limited Use, and GMRS Radio Services

Do Not Use if Applying for Ship Exemption

DO NOT MAIL THIS SCHEDULE TO THE FCC - KEEP IT FOR YOUR RECORDS

Form FCC 605, Schedule F, 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 to be used as a Temporary Operator Permit for the Ship, Aircraft, Restricted Radiotelephone, Restricted Radiotelephone-Limited Use, and GMRS Radio Services while your application is being processed by the FCC. In order for this Temporary Operator Permit to be valid, you must complete the FCC 605 Main Form and the appropriate Additional Data Schedule and submit them to the FCC. Ship Radio Stations should not use this Schedule F if installing equipment not shown on the current license, when renewing the ship station license, or if applying for a fleet license or a portable license. Aircraft Radio Stations should NOT use this Schedule F if they already hold a valid aircraft station license, or when renewing your aircraft station license, or if applying for a fleet license, or if they do not have an FAA Registration Number.

Schedule F Instructions

Certification Statements for a Temporary Operator Permit

By signing this Schedule F, the applicant certifies that the statements listed in this section are true, complete, correct, and made in good faith. If you cannot certify to the statements listed for your applicable radio service, you are not eligible for a Temporary Operator Permit.

Ship, Aircraft Station, and GMRS Additional Information

For Ship and Aircraft Stations Only: enter your Temporary Call Sign.

Ship Stations: For documented ships with or without an FCC call sign, your call sign will consist of the letters "KUS" followed by your six or seven digit documentation number, e.g., KUS234567. For Federal or State registered ships, the call sign will consist of the letter "K" followed by the ship's registration number, e.g., KNY1234A. For previously documented telegraph ships, 1600 gross tons and over or with telegraph survival craft, which will remain in documentation, the call sign will be the four letter call sign associated with that documentation number. If the ship does not have a State registration or Federal documentation, the call sign will consist of the name of the ship and the name of the licensee.

Aircraft Stations: Enter the FAA Registration Number as your temporary call sign.

GMRS Your temporary call sign will consist of the letters ‘WT’ plus your business or residence telephone number.

Signature

Enter the name of the person signing and the date the FCC 605 Main Form and Additional Data Schedule were submitted to the FCC. Sign and date the Temporary Operator Permit.

FCC 605	Temporary Operator Permit for the Ship,	Approved by OMB
Schedule F	Aircraft, Restricted Radiotelephone,	3060 - 0850
	Restricted Radiotelephone-Limited Use	See 605 Main Form Instructions
	and GMRS Radio Services Do Not Use if Applying for Ship Exemption	for public burden estimate

DO NOT MAIL THIS SCHEDULE TO THE FCC - KEEP IT FOR YOUR RECORDS

If you need a Temporary Operator Permit for the Ship, Aircraft, Restricted Radiotelephone, Restricted Radiotelephone-Limited Use or the GMRS Radio Services while your application is being processed by the FCC (refer to the instructions for restrictions):

1. Complete the FCC 605 Main Form and the appropriate Additional Data Schedule and submit them to the FCC.

2. Complete this FCC 605 Schedule F and keep it for your records.

Certification Statements for a Temporary Operator Permit

All applicants must certify:

I have applied for a Station License by submitting a completed and signed FCC 605 Main Form and appropriate Additional Data Schedule to the FCC, and that the information contained in that application is true and correct.

I have not been denied a license or had my license suspended or revoked by the FCC. I will obey all applicable laws, treaties, and regulations.

Ship, Aircraft Station, and GMRS Additional Information

Enter your temporary call sign (see instructions):

Signature

Typed or Printed Name:
Signature:
Date of Signature:	Date the FCC 605 Main Form and Additional Data Schedule were submitted to the FCC:

This temporary operator permit is valid for 90 days from the date the FCC 605 Main Form and the appropriate Additional Data Schedule were submitted to the FCC.

Your authority to operate your radio station under this temporary operator permit is subject to all applicable laws, treaties and regulations and is subject to right of control of the Government of the United States.

You must post this temporary operator permit at your radio station location.

FCC 605	FEDERAL COMMUNICATIONS COMMISSION	Approved by OMB
Schedule G		3060 - 0850 See 605 Main Form Instructions for public burden estimate
	Information and Instructions

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 Subpart T of Part 80, 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 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):

8) 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)

9) 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 Main Form - Instructions December 2023 - Page 2