Uniden PRESIDENT LTD 950 - Manual (Page 29)

FEDERAL COMMUNICATIONS COMMISSION
Approved by 0MB
3060-0096
Expires 07/31/93
See page two for information
regarding public burden estimate.
Application for Ship Radio Station License
A. CHECK BLOCK "A" ONLY IF SHIP IS RECREATIONAL OR VOLUNTARILY EQUIPPED. Complete applicable items I thru 13 and sign
application. You will automatically be authorized for VHF (156-158 MHz) & Class C EPIRB (156.75-156.8 MHz). Additional equipment other
than VHF & EPIRB must be requested in Item 16.
B CHECK BLOCK “B" ONLY IF SHIP IS COMPULSORY EQUIPPED (REQUIRED TO BE RADIO EQUIPPED). Complete appliLable
items 1 thru 18 and sign application. You will only be authorized for the specific category of transmitters that you have checked in Item 16. (See
instruction 16)
1. Type of Applicant (Check only one)
(I) Individual
(C) Corporation
0
(A) Association
(P) Partnership
__ (G) Governmental Entity
2. Applicant/Licensee Ñame (See instruction)
DBA Name (See instruction)
3. Mailing Address (Number and Street, P.O. Box or Rt. No.)
City State ZIP Code
4. Additional Partners
5. Purpose of Application
□ New Station □ Modification □ Renewal
67 Type of License(Check only one)
I I
(R) Regular [3 (F) Fleet (No. of ships)___________
□ (P) Portable (Give required showing)
7. Name of Ship (See instruction)
8. Official Nurnber of Ship (Coast Guard Documentation No. or State
Registration No.): If none, see instruction.
9. Call Sign (See instruction)
10. Class of Ship (See instruction)
(A) General:-------------------- (8) Specific:.
11. Relationship of Applicant to Ship (Check only one)
□ (A) Owner and/or Operator
□ (B) Other (Specify) ________________________
12. International Communications: (See instruction) YES NO
(A) Will Ship make international voyages? □ □
(B) Will Ship communicate with foreign coast sta- I I I I
tions other than those located in Canada or Mexico?
'—' '—'
13. (A) Are you requesting a Ship Station Identity yes NO
(9 digit number) to be used with Digital Selective __ , __
Calling Equipment? Q
(B) Have you been assigned a Ship Station tden- __ ^
tity Number for this Ship? I ]
I I
______If YES, show number___________________________
'—‘ *—’
14. Ship Radio Requirement Categories (See instruction)
□ (A) Radiotelegraph Station Required by Title I I I , Part I I of the
Communications Act or Safety ot Life at Sea Convention
E I (B) Radiotelephone Station Required by Title III, Part I I of the
*—'
Communications Act or Safety of Life at Sea Convention
I I (C) Radiotelephone Station Required by Title III, Part III ot the
’—'
Communications Act.
I I (D) RadiotelephoneStation Required by theGreatLakesRadio
^^
Agreement.
I I (E) Radiotelephone Station Required by the Vessel Bridge-To­
'
'
Bridge Radiotelephone Act.
15. Gross Tonnage and/or Length of Ship (See instruction)
(A) Gross Tons:_____________ (B) Feet:____________________
16 Category of Transmitters (See instruction)
Check No. (Caiegories)
VHF.'FM RadLOtdephonc(l56-lìl)MH?)AFPlRB(l56.75-l56.iìMHr)
EPlRB(l2f.5 and,.or 243 MHr)Ciais A. B. nr 5
SSB Radiotelephone (1600-4000 kHz)
SSB Radiotelephone (4000-23000 kHz)
Radar (2900-31«) MHz) and,'or (9300-9500 MHz)
Wl Radar(l40-1405GHz)
M l Radiutelegraph (2000-27500 k Hz) Except Direct Printing
Radiotelegraph (2000-27500 kHz) Direct Printing (NBPP, SITQR)
Radiotelegraph (405-535 kHz)
Survival Craft (500 kHz) (8364 kHz)
RTTY-Radioprinter (Under 1600 Gross Tons)
AMTS {216-220 MHz)
Eacsitnile
Satellite(l636 5-I644 MHz)
EPIRB(l645,5-l646 5 MHz)
m
EPIRB (406406 I MHz)
On-Board (457.525467.825 MHz)
OTHER (See instruction)
17. Radiotelegraph Morse Working Channel Series
(2000-27500 kHz):
W___________ W__________
18. Numerical Ship Station Identification
(A) Selective Call
Number (5 digits).
(B) INMARSAT
Number (7 digits),
CERTIFICATION, READ CAREFULLY BEFORE SIGNING
1. Applicant waives any claim to the use of any particular frequency regardless of prior use by license or otherwise.
2. Applicant will have unlimited access to the radio equipment and will control access to exclude unauthorized persons.
3. Neither applicant nor any member thereof is a foreign government or representative thereof.
4. Applicant certifies that alt statements made in this application and attachments are true, complete, correct and made in good faith. '
5. Applicant certifies that the signature is that of the individual, or partner, or officer or duly authorized employee of a corporation,or officer who is a
member of an unincorporated association, or appropriate elected or appointed official on behalf of a governmental entity.
WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMraiSONMENT. U.S. CODE TITLE 18, SECTION 1001
Typed/Printed Signor Name: Telephone No:
_i______!_____
Signature: Dale:
FCC Form 506, Page 1
Feb,ruary 1991