Laurel Form 605 - An FRN Number and Email address is required
Session Locaton
Session Date
Control Number
Applicant Information
.Last Name
Suffix
First Name
M.I.
Street Address
P.O. Box
City
State
Zip Code
Telephone Number
E-Mail Address
FRN Number-FCC Registration Number
Have you ever been convicted of a felony in any state or federal court?
* You must answer the above question if you are applying for a new license, upgrading your exisiting licensing or applying for a new call sign.
* Do not answer the above question if all you are doing is renewing your license, changing your name or changing your mailing address.
* If you answer "yes" then you must provide an explanation of the conviction to the FCC via mail or e-mail before your application will be processed by the FCC. If you fail to provide the explanation within 14 days, your application will be dismissed.
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Do you have another license applicaion on file that has not been acted upon?
If yes, what is the purpose of the other application?
Application File Number
Current License Information
Call Sign
Class
Expiration Date (MM/DD/YYYY)
For Volunteer Examiner Use Only
ID Check
License Check
Comments
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