FCC 605 FEDERAL COMMUNICATIONS COMMISSION 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. 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, by
calling the FCC’s Forms Distribution Center 800-418-FORM (3676), or from Federal Communications Commission Fax Information
System by dialing (202) 418-0177.

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 - Instructions

April 2014 - Page 1
 Overview

Purpose of Form Schedule B

Form FCC 605 is a multi-purpose form. It is used to apply for The Schedule for Additional Data for the Ship Radio Service
an authorization to operate radio stations, amend pending (47 CFR Part 80) is used to submit the required additional
applications, modify existing licenses, and perform a variety of parameters for ship stations including search & rescue
other miscellaneous transactions (refer to page 4 and 5 of information. This schedule is used in conjunction with the Main
these instructions for a detailed list) in the Wireless Form.
Telecommunications Bureau (WTB) radio services. This
includes the Ship Radio, Aircraft Radio, Amateur Radio, Schedule C
Restricted and Commercial Operator Radio, and the General The Schedule for Additional Data for the Aircraft Radio Service
Mobile Radio [GMRS] Services. The purpose of this form is to (47 CFR Part 87) is used to submit the required additional
collect data pertaining to the proposed request. This data is parameters for aircraft stations. This schedule is used in
used by the FCC to determine whether the public interest conjunction with the Main Form.
would be served by a grant of the request.
Schedule D
The Schedule for Additional Data for the Amateur Radio
Introduction Service (47 CFR Part 97) is used to submit the required
FCC Form 605 is a multi-part form comprising a main form and additional parameters for amateur stations. This schedule is
several schedules. Each application or amendment must used in conjunction with the Main Form.
contain only one Main Form (Pages 1 and 2).
Schedule E
The Schedule for Additional Data for Commercial Radio
Main Form Operators, Restricted Radiotelephone, and Restricted
The purpose of the Main Form is to obtain information Radiotelephone-Limited Use Radio Services (47 CFR Part 13)
sufficient to identify the filer and establish the filer’s basic is used to submit the required additional parameters for these
eligibility and qualifications. The Main Form also contains the licenses and permits. This schedule is used in conjunction
required certification and signature block. The Main Form is with the Main Form.
required for every application or amendment filed on FCC
Form 605. Schedule F
The Temporary Operator Permit for the Ship, Aircraft,
Restricted Radiotelephone, Restricted Radiotelephone-Limited
Schedules Use, and GMRS Radio Services is used to obtain a Temporary
The purposes of the optional schedules are as follows: Operator Permit while the Applicant's application is being
processed by the Commission. This schedule can only be
Schedule A completed and retained by the Applicant upon submission of a
The Schedule for Changes Affecting Multiple Call Signs or File completed and signed FCC 605 Main Form and appropriate
Numbers is used to submit global changes to items on the Additional Data Schedule to the FCC.
FCC 605 Main Form that affect either multiple call signs or
multiple file numbers. 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.
Schedules Required
If you are applying for an authorization which ULS Form/Schedule Title
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 Main Form 605 - Quick-Form Application for Authorization
Requirements 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 Main Form 605 - Quick-Form Application for Authorization
Radiotelephone, and Restricted Radiotelephone- Schedule E - Schedule for Additional Data for the Commercial Radio, Restricted Radiotelephone,
Limited Use Radio Services (47 CFR Part 13) and Restricted Radiotelephone-Limited Use Radio Services
General Mobile Radio Service [GMRS] Main Form 605 - Quick-Form Application for Authorization
(47 CFR Part 95)

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April 2014 - Page 2
 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, or FCC Form 1070Y. FCC Form 1070Y provides the fee information specifically for Form 605. For
assistance with fees applicable to the radio services governed by the FCC’s rules, call (877) 480-3201 (TTY 717-
338-2824). If you are required to submit payment with your manually filed application, you will also need FCC Form
159 (Fee Remittance Advice). The Fee Filing Guide, FCC Form 159 and FCC Form 1070Y can be downloaded
from the FCC’s web site at http://www.fcc.gov/formpage.html, by calling the FCC's Forms Distribution Center at
(800) 418-3676, or from FCC’s Fax Information System by dialing (202) 418-0177.

Paper applications requiring a fee must be 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.

Non-feeable paper applications should be mailed to Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA
17325-7245. Hand-deliveries and messenger-deliveries should be delivered to Federal Communications Commission, 1280 Fairfield
Road, Gettysburg, PA 17325.

Information on electronic filing is provided on Page 4 of these instructions.

Packages
If filing manually, the Main Form and the applicable schedules should be submitted as one package, stapled in the upper left corner.
The Main Form should be first with the schedules attached in alphabetical order. Applicants filing electronically are not required to
submit paper copies.

Paper Copies
The number of paper copies of this application required to be filed is one original. Applicants filing electronically are not required to
submit paper copies.

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 (TTY 717-338-2824), or visit the web at http://esupport.fcc.gov.

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April 2014 - Page 3
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 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, 1270 Fairfield Road, Gettysburg, PA 17325-7245. Hand deliveries and messenger deliveries should be delivered to
Federal Communications Commission, 1280 Fairfield Road, Gettysburg, PA 17325. 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).

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 constitutes
a need for a new license. A change in aircraft constitutes a need for a new license unless you are requesting a Transfer of
Control or Assignment of Authorization of an 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.

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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. 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. If you wish to consolidate DO and DM (Commercial Operator) licenses and renew at the same time, choose
purpose RM.

Simple Application Purpose & Requirements for Paper Submission 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)
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.

DU - Duplicate License: To request a hard copy duplicate of an existing license(s).

Mandatory items required for submission of “DU” purpose are as follows:

Item 1) Radio Service Code
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 26 & 27) Fee Status
Items 28, 29 & 30) Signature and Date

Note: Requests for a Duplicate/Replacement Restricted Radiotelephone Operator Permit licensed prior to May 21, 2001
should be filed as purpose New (NE) and Schedule E will also be required.

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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April 2014 - Page 5
 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)
Items 28, 29 & 30) 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. Send non-feeable packages to:

Federal Communications Commission

1270 Fairfield Road
Gettysburg, PA 17325-7245

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

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April 2014 - Page 6
 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 (TTY 717-338-2824) 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, duplicate, 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, cancellation or duplicate 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 (TTY 717-
338-2824) 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
(TTY 717-338-2824).

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, and telephone number of record. The FCC will send the authorization and notice of all final dispositions of an
application to this address. Failure to provide the FCC with a current and valid mailing address in the United States (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, by calling the
FCC's Forms Distribution Center at (800) 418-3676, or from Federal Communications Commission Fax Information System by dialing
(202) 418-0177. Note: Licensees should then associate their WTB call sign(s) electronically at http://wireless.fcc.gov/uls (click on
CORES/CALL SIGN REGISTRATION) or by manually submitting FCC Form 606. FCC Form 606 can also be obtained from any of the
aforementioned locales as FCC Form 160.

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) & 95.5(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, 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 an address where the
Applicant/Licensee can receive mail delivery by the United States Postal Service.

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.
FCC 605 - Instructions
April 2014 - Page 7
Items 22 and 23 Enter the Applicant’s/Licensee’s fax number and email address, if desired and available.

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 (TTY 717-338-2824).

General Certification Statements

Certification Statements for GMRS Applicants/Licensees

Certification Statements for Ship Applicants/Licensees (Including Ship Exemptions)

Signature

Items 28-30 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. Paper originals of applications must
bear an original signature, neither rubber-stamped nor photocopied signatures are acceptable. Any application lacking an original
signature may be dismissed for non-compliance with FCC rules. Be sure all necessary attachments are included with 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

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April 2014 - Page 8
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, Johston 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
MS Mississippi
MO Missouri Military:
MT Montana AE Armed Forces Europe, the Middle East, Africa
NE Nebraska and Canada
NV Nevada AP Armed Forces Pacific
NH New Hampshire AA Armed Forces Americas (except Canada)

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FCC 605 Quick-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 RO – Renewal Only WD – Withdrawal of Application
MD – Modification RM – Renewal / Modification DU – Duplicate License
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 File Number
application currently on file with the FCC.
5) If this request is for a Modification, Renewal Only, Renewal / Modification, Cancellation of License, Call Sign/Serial #
Duplicate 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 MM DD
requested expiration date of the authorization (this item is optional).
7) Does this filing request a Waiver of the Commission’s Rules? ( ) Yes No
If ‘Y’, attach the required showing as described in the instructions.
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/Licensees 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”.

FCC 605 – Main Form

April 2014 - Page 1
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

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) Applicant/Licensee certifies that he or she will comply with the requirement that use of frequencies 462.650, 467.650, 462.700
and 467.700 MHz is not permitted near the Canadian border North of Line A and East of Line C. These frequencies are used
throughout Canada and harmful interference is anticipated.
4) 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
28) Typed or Printed Name of Party Authorized to Sign
First Name: MI: Last Name: Suffix:

29) Title:

Signature: 30) 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

April 2014 - Page 2
 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB
FCC 605 3060 – 0850
Schedule A Information and Instructions See 601 Main Form Instructions
for public burden estimate

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, Renewal Only, Renewal/Modification,
Cancellation of License, Duplicate 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

April 2014 - Page 1
FCC 605 Schedule for Changes Affecting Multiple Call Signs Approved by OMB
Schedule A or File Numbers 3060 - 0850
See 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

April 2014 - Page 1
FCC 605 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB
Schedule B 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 boats in distress. If you were previously issued a Maritime Mobile Ship Identity (MMSI) by the FCC
for a DSC radio, you may update your ship station information with Boat U.S. free of charge using the FCC-issued MMSI unless the
FCC-issued MMSI ends in 3 zeros.
(http://www.boatus.com/mmsi/ ).

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).

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.

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

April 2014 - 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. If your ship is not named, and you have not provided a State Registration number in item 5, your application will be
returned.

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
FCC 605 Schedule B - Instructions
April 2014 - Page 2
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.

(A) RADIOTELEGRAPH STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT is required on:

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

April 2014 - Page 3
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 BY GREAT LAKES RADIO AGREEMENT
( ) Yes No
(E) RADIOTELEPHONE STATION REQUIRED BY THE VESSEL BRIDGE-TO-BRIDGE RADIOTELEPHONE
ACT ( ) Yes No

FCC 605 - Schedule B

April 2014 - 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: 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:

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

April 2014 - Page 2
FCC 605 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB
Schedule C 3060 - 0850
See 605 Main Form Instructions
Information and 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 C – Instructions

April 2014 – Page 1
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 - Schedule C

April 2014 – Page 1
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 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 D - Instructions

April 2014 - 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 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.

FCC 605 - Schedule D

April 2014 - Page 1
FCC 605 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB
Schedule E 3060 - 0850
See 605 Main Form Instructions
Information and 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 E – Instructions

April 2014 – Page 1
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 - Schedule E

April 2014 - Page 1
FCC 605 FEDERAL COMMUNICATIONS COMMISSION Approved by OMB
Schedule F 3060 - 0850
See 605 Main Form Instructions
Information and 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 Schedule F - Instructions

April 2014 - Page 1
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 for public burden estimate

Do Not Use if Applying for Ship Exemption

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 - Schedule F

April 2014 - Page 1
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

April 2014 – 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):______________________________________________________________________________

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 - Schedule G

April 2014 – Page 1