Process for Licensing for General Mobile Radio Service (GMRS)

Size: px
Start display at page:

Download "Process for Licensing for General Mobile Radio Service (GMRS)"

Transcription

1 The United States permits use by an adult individual who possesses a valid GMRS license, as well as his or her immediate family members. Immediate relatives of the GMRS system licensee are entitled to communicate among themselves for personal or business purposes. Go to website:

2 Both "First Name" and "Last Name" of the Individual Entity are required! "Social Security Number" or an "Exception Reason" is required (not both), and SSN must be 9-digits without dash! "Position"(i.e., job titile) or "First Name + Last Name" of Contact Information is required! "Address Line 1" is required! "City" is required! "Zip Code" is required, and must be 5 or 9 digits! Password is required! "Personal Security Question" is required!

3 Once you have your FCC Registration Number (FRN) Return to:

4 Fill in and continue to summary and then certification. This is where you will be asked to pay for the license $ 65. The United States permits use by an adult individual who possesses a valid GMRS license, as well as his or her immediate family members. Immediate relatives of the GMRS system licensee are entitled to communicate among themselves for personal or business purposes.

5 FCC 605 Schedule F FEDERAL COMMUNICATIONS COMMISSION Information and Instructions 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 General Mobile Radio Services. Temporary Operator Permit to be valid, you must complete the FCC 605 Main Form and submit it to the FCC. 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. GMRS Additional Information 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.

6 FCC 605 Temporary Operator Permit for the Schedule F GMRS Radio Services DO NOT MAIL HIS SCHEDULE TO THE FCC - KEEP IT FOR YOUR RECORDS! 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. Certification Statements for a Temporary Operator Permit WT (phone last four digits of your number) Example: WT6207 Enter your temporary call sign: Signature Typed or Printed Name: Signature: Date of Signature: Date the FCC 605 Main Form were submitted to the FCC: This temporary operator permit is valid for 90 days from the date the FCC 605 Main Form 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 or carry a copy with you.

7 Your Done Get on the Air! For more information contact us at: Cordnerradios.com

Quick-Form Application for Authorization in the Ship, Aircraft, Amateur, Restricted and Commercial Operator, and General Mobile Radio Services

Quick-Form Application for Authorization in the Ship, Aircraft, Amateur, Restricted and Commercial Operator, and General Mobile Radio Services 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,

More information

Quick-Form Application for Authorization in the Ship, Aircraft, Amateur, Restricted and Commercial Operator, and General Mobile Radio Services

Quick-Form Application for Authorization in the Ship, Aircraft, Amateur, Restricted and Commercial Operator, and General Mobile Radio Services 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,

More information

Reference Copy Only. Do Not Mail to the FCC as an Application.

Reference Copy Only. Do Not Mail to the FCC as an Application. Only. Do Not Mail to the FCC as an Application. Submitted: 09/20/2005 at 13:50:38 File Number: 0002321287 FCC 601 FCC Application for Wireless Telecommunications Bureau Approved by OMB Main Form Radio

More information

Approved by OMB (March 2011)

Approved by OMB (March 2011) Federal Communications Commission Washington, D.C. 20554 FCC 303-S Approved by OMB 3060-0110 (March 2011) APPLICATION FOR RENEWAL OF BROADCAST STATION LICENSE Read INSTRUCTIONS Before Filling Out Form

More information

Page 1 of 4 Federal Communications Commission Washington, D.C. 20554 FCC 303-S Approved by OMB 3060-0110 (March 2011) APPLICATION FOR RENEWAL OF BROADCAST STATION LICENSE Read INSTRUCTIONS Before Filling

More information

Reference Copy Only. Do Not Mail to the FCC as an Application.

Reference Copy Only. Do Not Mail to the FCC as an Application. Only. Do Not Mail to the FCC as an Application. Submitted: 02/18/2010 at 15:19:56 File Number: 0004129997 FCC 601 FCC Application for Radio Service Authorization: Approved by OMB Form Wireless Telecommunications

More information

FCC 601 FCC Application for Radio Service Authorization: Approved by OMB

FCC 601 FCC Application for Radio Service Authorization: Approved by OMB FCC 601 FCC Application for Radio Service Authorization: Approved by OMB Main Form Wireless Telecommunications Bureau 3060-0798 Public Safety and Homeland Security Bureau 1) Radio Service Code: 1a) Existing

More information

Approved by OMB (January 2001)

Approved by OMB (January 2001) Federal Communications Commission Washington, D.C. 20554 FCC 345 Section I - General Information 1. Legal Name of the Applicant EDGEWATER BROADCASTING, INC. Mailing Address P.O. BOX 5725 Approved by OMB

More information

TELECOMMUNICATIONS (LICENSING CLASSIFICATION, AUTHORISATION AND FEE STRUCTURE), REGULATIONS S.I. No. 110 of 2002 ARRANGEMENT OF REGULATIONS

TELECOMMUNICATIONS (LICENSING CLASSIFICATION, AUTHORISATION AND FEE STRUCTURE), REGULATIONS S.I. No. 110 of 2002 ARRANGEMENT OF REGULATIONS BELIZE: TELECOMMUNICATIONS (LICENSING CLASSIFICATION, AUTHORISATION AND FEE STRUCTURE), REGULATIONS 2002 1. Short title 2. Commencement 3. Interpretation 4. Class of Licences 5. Application for a licence

More information

CDBS Print http://fjallfoss.fcc.gov/cgi-bin/ws.exe/prod/cdbs/forms/prod/cdbsmenu.hts?context=25&f... Page 1 of 6 10/14/2008 Federal Communications Commission Washington, D.C. 20554 FCC 345 Section I -

More information

Florida Department of Agriculture and Consumer Services Division of Licensing

Florida Department of Agriculture and Consumer Services Division of Licensing ADAM H. PUTNAM COMMISSIONER Florida Department of Agriculture and Consumer Services Division of Licensing APPLICATION FOR CLASS CC PRIVATE INVESTIGATOR INTERN LICENSE Chapter 493, Florida Statutes Post

More information

Miami County Traffic Safety Program

Miami County Traffic Safety Program Miami County Traffic Safety Program - Your application for the Miami County Municipal Court Traffic Safety Program MUST be approved by the Court before payment can be accepted. - The Program fee is $150.00,

More information

APPLICATION FOR ADULT ENTERTAINMENT LICENSE/YEARLY RENEWAL

APPLICATION FOR ADULT ENTERTAINMENT LICENSE/YEARLY RENEWAL APPLICATION FOR ADULT ENTERTAINMENT LICENSE/YEARLY RENEWAL City of Winter Park, Building Department 401 S. Park Ave., Winter Park, FL 32789 407-599-3237 Fees: Adult Entertainment Application Fee (non-refundable):

More information

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. APPLICATION REQUIREMENTS

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. APPLICATION REQUIREMENTS State of Florida Department of Business and Professional Regulation Florida Real Estate Appraisal Board Application for Registering an Appraisal Management Company Form # DBPR FREAB-1 1 of 10 APPLICATION

More information

New Mexico Bingo & Raffle Distributor/ Manufacturer Renewal Application

New Mexico Bingo & Raffle Distributor/ Manufacturer Renewal Application New Mexico Bingo & Raffle Distributor/ Manufacturer Renewal Application (EFFECTIVE SEPTEMBER 1, 2017 4900 Alameda Blvd. NE Albuquerque, NM 87113 Phone: (505 841-9700 Fax: (505 841-9725 Website: www.nmgcb.org

More information

City County Zip Code. Date(s) permit being applied for: MONTH/YEAR SUNDAY DATE FEES DUE

City County Zip Code. Date(s) permit being applied for: MONTH/YEAR SUNDAY DATE FEES DUE 1350 STATE OF SOUTH CAROLINA DEPARTMENT OF REVENUE APPLICATION FOR BUSINESS ANNUAL LOCAL OPTION PERMIT Mail to: SCDOR, ABL Section, Columbia, SC 29214-0907 Telephone: (803 898-5864 DOR Website: www.sctax.org

More information

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing.

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. State of Florida Department of Business and Professional Regulation Board of Architecture and Interior Design Application for Licensure by NCARB Endorsement Form # DBPR AR 6 1 of 6 APPLICATION CHECKLIST

More information

CITY OF WEST CHICAGO LIQUOR LICENSE APPLICATION

CITY OF WEST CHICAGO LIQUOR LICENSE APPLICATION CITY OF WEST CHICAGO LIQUOR LICENSE APPLICATION (Fill Out Completely Attach Additional Sheets as Necessary to Provide Complete Answers to Each Question) 1. TYPE OF APPLICATION: New License (If Applicant

More information

Florida Department of Agriculture and Consumer Services Division of Licensing

Florida Department of Agriculture and Consumer Services Division of Licensing ADAM H. PUTNAM COMMISSIONER Florida Department of Agriculture and Consumer Services Division of Licensing APPLICATION FOR CLASS G STATEWIDE FIREARM LICENSE Chapter 493, Florida Statutes Post Office Box

More information

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. APPLICATION REQUIREMENTS

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. APPLICATION REQUIREMENTS State of Florida Building Code Administrators and Inspectors Board Application to Reinstate Null and Void Certification Form # DBPR BCAIB 9 1 of 5 APPLICATION CHECKLIST IMPORTANT Submit all items on the

More information

CAMPAIGN REGISTRATION STATEMENT STATE OF WISCONSIN GAB-1

CAMPAIGN REGISTRATION STATEMENT STATE OF WISCONSIN GAB-1 CAMPAIGN REGISTRATION STATEMENT STATE OF WISCONSIN GAB-1 FOR OFFICE USE ONLY IF A CANDIDATE DOES NOT FILE THIS STATEMENT BY THE DEADLINE FOR FILING NOMINATION PAPERS, THE CANDIDATE S NAME WILL NOT BE PLACED

More information

PROTECTION FROM ABUSE APPLICATION CONTACT INFORMATION SHEET FOR DISTRICT ATTORNEYS OFFICE USE ONLY

PROTECTION FROM ABUSE APPLICATION CONTACT INFORMATION SHEET FOR DISTRICT ATTORNEYS OFFICE USE ONLY PLAINTIFF S INFORMATION Name (full): DOB: SSN: Address: Work Place: Home Phone #: Cell #: Work #: PROTECTION FROM ABUSE APPLICATION CONTACT INFORMATION SHEET FOR DISTRICT ATTORNEYS OFFICE USE ONLY Emergency

More information

Approved by OMB (September 2009)

Approved by OMB (September 2009) 1 of 5 10/31/2016 8:06 AM Federal Communications Commission Washington, D.C. 20554 FCC 345 Approved by OMB 3060-0075 (September 2009) APPLICATION FOR TRANSFER OF CONTROL OF A CORPORATE LICENSEE OR PERMITTEE,

More information

State of Texas Jury Management System. User Manual

State of Texas Jury Management System. User Manual 2014 State of Texas Jury Management System User Manual 1 Revision History Version Author Revision Date Comments 0.0 L. Ford 01/07/2016 Initial Version 2 Table of Contents 1. Overview... 5 2. System Requirements...

More information

CAMPAIGN REGISTRATION STATEMENT STATE OF WISCONSIN ETHCF-1

CAMPAIGN REGISTRATION STATEMENT STATE OF WISCONSIN ETHCF-1 CAMPAIGN REGISTRATION STATEMENT STATE OF WISCONSIN ETHCF-1 FOR OFFICE USE ONLY IF A CANDIDATE DOES NOT FILE THIS STATEMENT BY THE DEADLINE FOR FILING NOMINATION PAPERS, THE CANDIDATE'S NAME WILL NOT BE

More information

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS MICHIGAN ADMINISTRATIVE HEARING SYSTEM OCCUPATIONAL BOARDS

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS MICHIGAN ADMINISTRATIVE HEARING SYSTEM OCCUPATIONAL BOARDS DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS MICHIGAN ADMINISTRATIVE HEARING SYSTEM OCCUPATIONAL BOARDS (By authority conferred on the executive director of the Michigan administrative hearing system

More information

SMALL CLAIMS & JUSTICE CIVIL INFORMATION SHEET (PLEASE READ CAREFULLY BEFORE COMPLETING THE PETITION)

SMALL CLAIMS & JUSTICE CIVIL INFORMATION SHEET (PLEASE READ CAREFULLY BEFORE COMPLETING THE PETITION) SMALL CLAIMS & JUSTICE CIVIL INFORMATION SHEET (PLEASE READ CAREFULLY BEFORE COMPLETING THE PETITION) SMALL CLAIMS - $106.00 JUSTICE CIVIL - $106.00 ROCKWALL COUNTY ROCKWALL COUNTY (ASK CLERK FOR OUT OF

More information

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing.

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. State of Florida Department of Business and Professional Regulation Board of Architecture and Interior Design Application for Licensure by State or Direct Endorsement Form # DBPR AR 8 1 of 7 APPLICATION

More information

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing.

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. State of Florida Department of Business and Professional Regulation Asbestos Licensing Unit Application for Financially Responsible Officer Form # DBPR ALU 5 1 of 9 APPLICATION CHECKLIST IMPORTANT Submit

More information

Application for Middleton Firefighter Middleton Fire District 7600 University Ave, Middleton WI 53562

Application for Middleton Firefighter Middleton Fire District 7600 University Ave, Middleton WI 53562 Application for Middleton Firefighter Middleton Fire District 7600 University Ave, Middleton WI 53562 Instructions: Please type or print in ink an answer to every question, if an answer does not apply,

More information

AMBULANCE LICENSE APPLICATION

AMBULANCE LICENSE APPLICATION Rahm Emanuel Mayor City of Chicago Department of Business Affairs and Consumer Protection Public Vehicle Operations Division 2350 West Ogden Avenue, 1st Floor Chicago, Illinois 60608 (312) 746-4200 (312)

More information

Missoula Police Department Policy Manual. Foreign National Detention/arrest/Death/Diplomatic Immunity Effective Date: 6/8/2017

Missoula Police Department Policy Manual. Foreign National Detention/arrest/Death/Diplomatic Immunity Effective Date: 6/8/2017 Subject: Missoula Police Department Policy Manual Foreign National Detention/arrest/Death/Diplomatic Immunity Effective Date: 6/8/2017 Chapter References: 5 Original Date: 09/20/2007 Policy # 5.60 Next

More information

GRAND RONDE GAMING COMMISSION

GRAND RONDE GAMING COMMISSION GRAND RONDE GAMING COMMISSION Gaming License Last Name First Name Middle Name Aliases ( Please list name and indicate whether name is nickname, maiden name, other name change(s) - whether legal or otherwise.)

More information

STATE OF FLORIDA OFFICE OF FINANCIAL REGULATION APPLICATION FOR CONSUMER FINANCE COMPANY LICENSE CHAPTER 516, FLORIDA STATUTES

STATE OF FLORIDA OFFICE OF FINANCIAL REGULATION APPLICATION FOR CONSUMER FINANCE COMPANY LICENSE CHAPTER 516, FLORIDA STATUTES STATE OF FLORIDA OFFICE OF FINANCIAL REGULATION APPLICATION FOR CONSUMER FINANCE COMPANY LICENSE CHAPTER 516, FLORIDA STATUTES GENERAL INSTRUCTIONS Form OFR-516-01 is the form used by Consumer Finance

More information

Guidelines for the Type Approval Of Licence Exempt Radio Spectrum Devices

Guidelines for the Type Approval Of Licence Exempt Radio Spectrum Devices Guidelines for the Type Approval Of Licence Exempt Radio Spectrum Devices GUIDELINES ECS 02/2013 Issue Date: 23 rd January, 2013 Version Control Version Issue Date Reason for Issuance 1.0 23 January 2013

More information

Licensing and Permitting Section MEMORANDUM

Licensing and Permitting Section MEMORANDUM South Carolina Department of Labor, Licensing and Regulation Office of State Fire Marshal 141 Monticello Trail Columbia, SC 29203 Phone: 803-896-9800 Fax: 803-896-9806 www.llronline.com Licensing and Permitting

More information

STATE OF FLORIDA OFFICE OF FINANCIAL REGULATION. Application for Registration as Consumer Collection Agency Chapter 559 Part VI, Florida Statutes

STATE OF FLORIDA OFFICE OF FINANCIAL REGULATION. Application for Registration as Consumer Collection Agency Chapter 559 Part VI, Florida Statutes STATE OF FLORIDA OFFICE OF FINANCIAL REGULATION Application for Registration as Consumer Collection Agency Chapter 559 Part VI, Florida Statutes Consumer Collection Agency Consumer collection agency means

More information

THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY Department of Criminal Justice Information Services

THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY Department of Criminal Justice Information Services THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY Department of Criminal Justice Information Services 200 Arlington Street, Suite 2200, Chelsea, MA 02150 mass.gov/cjis TTY:

More information

By-Laws for the, Ocean County, New Jersey (club name) Section 1 Name The name of this organization shall be (club name)

By-Laws for the, Ocean County, New Jersey (club name) Section 1 Name The name of this organization shall be (club name) By-Laws for the, Ocean County, New Jersey (club name) ARTICLE I Name/Identity Section 1 Name The name of this organization shall be (club name) Section 2 Motto The club motto shall be To Make the Best

More information

ID ACCESS BADGE APPLICATION FOR AOA and NON-SIDA

ID ACCESS BADGE APPLICATION FOR AOA and NON-SIDA ID ACCESS BADGE APPLICATION FOR AOA and NON-SIDA 3880 NE 39 th Avenue, Suite A Airport Operations Dept. Gainesville, Fl 32609 Phone: 352-373-0249 Fax: 352-374-8368 AIRPORT OFFICE USE ONLY BADGE TYPE BADGE

More information

NEW JERSEY BOARD OF PUBLIC UTILITIES 44 South Clinton Avenue 3 rd Floor, Suite 314, P.O. Box 350 Trenton, New Jersey

NEW JERSEY BOARD OF PUBLIC UTILITIES 44 South Clinton Avenue 3 rd Floor, Suite 314, P.O. Box 350 Trenton, New Jersey NEW JERSEY BOARD OF PUBLIC UTILITIES 44 South Clinton Avenue 3 rd Floor, Suite 314, P.O. Box 350 Trenton, New Jersey 08625-0350 ELECTRIC POWER and/or GAS SUPPLIER LICENSE RENEWAL APPLICATION Please Type

More information

State of Maine Office of the Secretary of State

State of Maine Office of the Secretary of State State of Maine Office of the Secretary of State Application for a Notary Public Commission This section is for office use only. Notary Public #: Commission issued: for a Maine Resident Please read these

More information

Please mail your completed application, documentation and required fee(s) to: 2601 Blair Stone Road Tallahassee, Fl

Please mail your completed application, documentation and required fee(s) to: 2601 Blair Stone Road Tallahassee, Fl State of Florida Department of Business and Professional Regulation Board of Auctioneers Application for Auction Business Licensure Form # DBPR AU-4155 1 of 7 APPLICATION CHECKLIST IMPORTANT Submit all

More information

1. "Applicant" means a person applying for registration under this chapter.

1. Applicant means a person applying for registration under this chapter. IOWA 9D.1 Definitions. 1. "Applicant" means a person applying for registration under this chapter. 2. "Customer" means a person who is offered or who purchases travel services. 3. "Registrant" means a

More information

The event is under the patronage of the European Parliament

The event is under the patronage of the European Parliament The event is under the patronage of the European Parliament Exhibition «Mon EUROPE» Call for participation You live Europe everyday? Europe gave you beautiful memories? Celebrate with us the 60th anniversary

More information

Probate Court of Cuyahoga County, Ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge APPLICATION FOR APPOINTMENT OF TRUSTEE

Probate Court of Cuyahoga County, Ohio Anthony J. Russo, Presiding Judge Laura J. Gallagher, Judge APPLICATION FOR APPOINTMENT OF TRUSTEE 9 WRONGFUL DEATH TRUST 9 TESTAMENTARY TRUST 9 SPECIAL NEEDS TRUST APPLICATION FOR APPOINTMENT OF TRUSTEE Hereby make(s) application to be appointed Trustee(s) of the: 9 Wrongful Death Trust fbo as the

More information

INSTRUCTIONS AND REQUIREMENTS FOR CHANGE OF OFFICER APPLICATION AND TRANSFER OF STOCK (0% - 25% TAXI ONLY)

INSTRUCTIONS AND REQUIREMENTS FOR CHANGE OF OFFICER APPLICATION AND TRANSFER OF STOCK (0% - 25% TAXI ONLY) City of Chicago Department of Business Affairs and Consumer Protection Public Vehicle Operations Division 2350 W. Ogden Chicago, IL 60608 312-746-4200 Fax 312-746-9405 BACPPV@CITYOFCHICAGO.ORG WWW.CITYOFCHICAGO.ORG/BACP

More information

PROCEDURE FOR OBTAINING A PERMIT TO SELL BEER IN THE CITY OF BRISTOL TENNESSEE

PROCEDURE FOR OBTAINING A PERMIT TO SELL BEER IN THE CITY OF BRISTOL TENNESSEE PROCEDURE FOR OBTAINING A PERMIT TO SELL BEER IN THE CITY OF BRISTOL TENNESSEE 1. THE APPLICATION: Each applicant must obtain from the Police Department a State Application and complete it in full, including

More information

City of Mattoon Fire Department

City of Mattoon Fire Department City of Mattoon Fire Department Thank you for your interest in the City of Mattoon Fire Department. Please read this 16-page document carefully, paying particular attention to deadlines and required documents:

More information

BOTH SIGNATURES MUST BE IN BLUE INK

BOTH SIGNATURES MUST BE IN BLUE INK PROCEDURE FOR ASSOCIATION OF COUNSEL PURSUANT TO SCR 42 BOTH SIGNATURES MUST BE IN BLUE INK THIS APPLICATION IS NOT FOR USE IN FEDERAL COURTS. DO NOT CHANGE OR OMIT ANY WORDING ON THE APPLICATION. Original

More information

PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGE

PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGE INSTRUCTIONS FOR NAME CHANGE 1. Obtain the name change documents from the clerk in the Marriage License Department. Please specify whether it is a name change for an adult or for a minor. NO NAME CHANGE

More information

Plaintiff, v. Collective Action Nicka & Associates, Inc.,

Plaintiff, v. Collective Action Nicka & Associates, Inc., IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF TEXAS SHERMAN DIVISION Beth Degrassi, individually and on behalf of all others similarly situated, CA No.: 15-cv-577-ALM Plaintiff, v. Collective

More information

Current Reporting Period From To (MM/DD/YYYY) (MM/DD/YYYY) (REPORTING DATES MUST BE FOR THE PAST YEAR AND MAY NOT REPORT INTO THE FUTURE.

Current Reporting Period From To (MM/DD/YYYY) (MM/DD/YYYY) (REPORTING DATES MUST BE FOR THE PAST YEAR AND MAY NOT REPORT INTO THE FUTURE. District Court Denver Probate Court County, Colorado Court Address: In the Interest of: Minor Attorney or Party Without Attorney (Name and Address): Case Number: COURT USE ONLY Phone Number: E-mail: FAX

More information

Sudbury Police Department

Sudbury Police Department Sudbury Police Department 75 Hudson Road Sudbury, MA 01776 Business (978) 443-1042 Fax (978) 443-1045 APPLICATION FOR NEW/RENEWAL OF FIREARMS IDENTIFICATION CARD OR LICENSE TO CARRY FIREARMS NEW APPLICANTS

More information

Instructions for Applying to be Reinstated After 5 Years

Instructions for Applying to be Reinstated After 5 Years Instructions for Applying to be Reinstated After 5 Years If you have been inactive for more than five consecutive years as a real estate salesperson or broker you must complete this application. If your

More information

STATE OF NEW JERSEY Division of Gaming Enforcement VENDOR REGISTRATION SUPPLEMENTAL DISCLOSURE FORM

STATE OF NEW JERSEY Division of Gaming Enforcement VENDOR REGISTRATION SUPPLEMENTAL DISCLOSURE FORM STATE OF NEW JERSEY Division of Gaming Enforcement VENDOR REGISTRATION SUPPLEMENTAL DISCLOSURE FORM Vendor Registration Supplemental Disclosure Form I. COMPLETING THIS FORM: INSTRUCTIONS A. This form is

More information

AMENDMENT (To amend, circle or identify item(s) being amended.) TERMINATE RELATIONSHIP (eg: employment, sponsorship, etc) SURRENDER

AMENDMENT (To amend, circle or identify item(s) being amended.) TERMINATE RELATIONSHIP (eg: employment, sponsorship, etc) SURRENDER FORM MU4 Date of filing (MM/DD/YYYY): MULTISTATE UNIFORM INDIVIDUAL LICENSURE FORM NEW APPLICATION AMENDMENT (To amend, circle or identify item(s) being amended.) ESTABLISH RELATIONSHIP TERMINATE RELATIONSHIP

More information

REGISTER OF ELECTORS. Application for inclusion in the Supplement to the 2018/2019 Register of Electors

REGISTER OF ELECTORS. Application for inclusion in the Supplement to the 2018/2019 Register of Electors Form Version: 08/2015 REGISTER OF ELECTORS RFA 2 Application for inclusion in the Supplement to the 2018/2019 Register of Electors Please read the notes carefully before completing the form. 1. Name: [Please

More information

ORDINANCE. WHEREAS, Resolution called for studies on how to reduce Seattleites use of hard-torecycle

ORDINANCE. WHEREAS, Resolution called for studies on how to reduce Seattleites use of hard-torecycle September, 0 0 Form Last Revised on May, 0 ORDINANCE AN ORDINANCE relating to solid waste reduction; establishing license requirements for publishers of yellow pages phone books; establishing an opt-out

More information

JEFFERSON COUNTY BAIL BOND BOARD APPLICATION FOR SURETY LICENSE

JEFFERSON COUNTY BAIL BOND BOARD APPLICATION FOR SURETY LICENSE JEFFERSON COUNTY BAIL BOND BOARD APPLICATION FOR SURETY LICENSE NOTICE: Pursuant to Occupations Code Chapter 1704.162 Section (2) (b) and the Jefferson County Bail Bond Board local rules, failure to submit

More information

State of Florida Department of Business and Professional Regulation Board of Professional Geologists

State of Florida Department of Business and Professional Regulation Board of Professional Geologists State of Florida Department of Business and Professional Regulation Board of Professional Geologists Application for License from Null and Void (Expired License) Form # DBPR PG 4705 1 of 7 APPLICATION

More information

BYLAWS OF WESTERN WASHINGTON MEDICAL SERVICES EMERGENCY COMMUNICATIONS

BYLAWS OF WESTERN WASHINGTON MEDICAL SERVICES EMERGENCY COMMUNICATIONS ARTICLE I MEMBERSHIP 1.1. Jurisdiction: The EMERGENCY COMMUNICATIONS. (WWMSEC) is an organization comprised exclusively of volunteer communicators and support personnel, is not dependent on any commercial

More information

Florida Court Interpreter Program. Application for Court Interpreter Registration

Florida Court Interpreter Program. Application for Court Interpreter Registration Florida Court Interpreter Program Application for Court Interpreter Registration Rev. 10/27/2016 Table of Contents Application Instructions and Board Operating Procedures... 3 Applicant Information...

More information

Montana. Registration Deadline M T W Th F Sa Su. Database Implementation Status. Entering Voter Registration Information. Voter Registration Form

Montana. Registration Deadline M T W Th F Sa Su. Database Implementation Status. Entering Voter Registration Information. Voter Registration Form Montana Registration Deadline M T W Th F Sa Su Forms must be received in person or postmarked 30 days before an election. 1 As of July 1, 2006, Montana will also provide a late registration option: an

More information

Request for Status Information Letter

Request for Status Information Letter Request for Status Information Letter I am requesting a Status Information Letter. I am a male who is not registered with Selective Service. I am now 26 years old or older, and was born after December

More information

Montgomery County Ethics Committee 501 N. Thompson, Suite 300, Conroe, Texas (936)

Montgomery County Ethics Committee 501 N. Thompson, Suite 300, Conroe, Texas (936) SWORN COMPLAINT BEFORE THE MONTGOMERY COUNTY ETHICS COMMITTEE An individual must be at least 18 years of age to be eligible to submit a sworn complaint to the Montgomery County Ethics Committee, c/o the

More information

Legal documentation (Trust Instrument/Trust Agreement) exists The membership requirements are met (See item 1. in the TRUST ACCOUNT AGREEMENT AND

Legal documentation (Trust Instrument/Trust Agreement) exists The membership requirements are met (See item 1. in the TRUST ACCOUNT AGREEMENT AND Legal documentation (Trust Instrument/Trust Agreement) exists The membership requirements are met (See item 1. in the TRUST ACCOUNT AGREEMENT AND DISCLOSURE for federal credit union mandated membership

More information

Traffic Diversion Application. Last Name First Name Middle Initial Address City State Zip. Contact me by: Mail or

Traffic Diversion Application. Last Name First Name Middle Initial Address City State Zip.  Contact me by: Mail or Office of the WYANDOTTE COUNTY DISTRICT ATTORNEY DISTRICT ATTORNEY Mark A. Dupree, Sr. 29 TH JUDICIAL DISTRICT OF KANSAS Traffic Diversion Application Last Name First Name Middle Initial Address City State

More information

NEW HIRE / REPLACEMENT INFORMATION

NEW HIRE / REPLACEMENT INFORMATION NEW HIRE / REPLACEMENT INFORMATION NAME: ADDRESS: CITY, STATE, & ZIP: SOCIAL SECURITY #: DATE OF BIRTH: LOCAL NUMBER FILING STATUS: SINGLE OR MARRIED - PLEASE CIRCLE ONE NUMBER OF DEPENDENTS: CLASS: (1

More information

APPLICATION FOR CERTIFICATION AS A BIOLOGICAL WASTEWATER TREATMENT OPERATOR

APPLICATION FOR CERTIFICATION AS A BIOLOGICAL WASTEWATER TREATMENT OPERATOR South Carolina Department of Labor, Licensing and Regulation South Carolina Environmental Certification Board P.O. Box 11409 Columbia, SC 29211 Phone: 803-896-4430 Fax: 803-896-4424 www.llr.state.sc.us/pol/environmental/

More information

1) Applicants will no longer be required to obtain fingerprints from their local police departments;

1) Applicants will no longer be required to obtain fingerprints from their local police departments; June 1, 2009 RE: Application for Non-resident Temporary License to Carry Firearms Dear Applicant: Beginning August 1 st, 2009, all new and renewal non-resident temporary licenses to carry firearms (LTC)

More information

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing.

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. State of Florida Department of Business and Professional Regulation Florida Real Estate Appraisal Board Application for Certified Appraiser by Reciprocity Form # DBPR FREAB 12 1 of 7 APPLICATION CHECKLIST

More information

REGISTER OF ELECTORS. Application for inclusion in the Supplement to the 2018/2019 Register of Electors

REGISTER OF ELECTORS. Application for inclusion in the Supplement to the 2018/2019 Register of Electors Non-Directed form amended September 2017 REGISTER OF ELECTORS RFA 2 Application for inclusion in the Supplement to the 2018/2019 Register of Electors Please read the notes carefully before completing the

More information

2018 Reciprocal Certification Request State of North Dakota

2018 Reciprocal Certification Request State of North Dakota 2018 Reciprocal Certification Request State of North Dakota Personal Information Name Address Business Information Name of Business Address Phone Date of Birth State of Residence Email Phone Fax Email

More information

INFRASTRUCTURE PROVIDER SUBLICENSEE WIRELESS INSTALLATION AGREEMENT BETWEEN CITY PUBLIC SERVICE OF SAN ANTONIO AND [ ]

INFRASTRUCTURE PROVIDER SUBLICENSEE WIRELESS INSTALLATION AGREEMENT BETWEEN CITY PUBLIC SERVICE OF SAN ANTONIO AND [ ] INFRASTRUCTURE PROVIDER SUBLICENSEE WIRELESS INSTALLATION AGREEMENT BETWEEN CITY PUBLIC SERVICE OF SAN ANTONIO AND [ ] CPS ENERGY INFRASTRUCTURE PROVIDER SUBLICENSEE WIRELESS INSTALLATION AGREEMENT NO.

More information

!"#$% & '%&!!&( (!( ! (%! )%* % %%! )%!)!&%( &!'!% ) % ) &!-&! %!%*!%!!! ( './&0 &!1! 2! 3! '& &&.!' ! (&%'!!!)!%1! ' %!! 2!!! %!'!! *)!

!#$% & '%&!!&( (!( ! (%! )%* % %%! )%!)!&%( &!'!% ) % ) &!-&! %!%*!%!!! ( './&0 &!1! 2! 3! '& &&.!' ! (&%'!!!)!%1! ' %!! 2!!! %!'!! *)! !"#$% & '%&!!&( (!(! (%! )%* % %%! )%!)!&%( &!'!%!(!(!!'(!' ('(+(+&! ('%!%(!&( %*('!%!!!!&('(,(!!)!&(!& ) % ) &!-&! %!%*!%!!! ( './&0 &!1! 2! 3! '& &&.!'! (&%'!!!)!%1! ' %!! 2!!! %!'!! *)!1 ' +&)!'!&!,%

More information

City of Virginia Beach

City of Virginia Beach P.O. Box 6247 Virginia Beach, Virginia 23456-0247 You have been appointed as an Officer of Election for a term of two years beginning March 1, 2014 and ending on February 28, 2016 plus the Presidential

More information

FCC 323-E Ownership Report For Noncommercial Educational Broadcast Station

FCC 323-E Ownership Report For Noncommercial Educational Broadcast Station DBS Print Federal Communications Commission Washington, D.C. 20554 Approved by OMB 3060-0084 (June 2002) FCC 323-E Ownership Report For Noncommercial Educational Broadcast Station Read INSTRUCTIONS Before

More information

CANADA Industrial Design Regulations as amended by SOR/ Last amended on October 5, 2008 Current to October 31, 2012

CANADA Industrial Design Regulations as amended by SOR/ Last amended on October 5, 2008 Current to October 31, 2012 CANADA Industrial Design Regulations as amended by SOR/2008-268 Last amended on October 5, 2008 Current to October 31, 2012 TABLE OF CONTENTS 1. INTERPRETATION 2. FILING OF APPLICATIONS 3. CORRESPONDENCE

More information

BF1/US_en_ Application for dispensation before a residence permit in the areas of asylum and family reunification has lapsed

BF1/US_en_ Application for dispensation before a residence permit in the areas of asylum and family reunification has lapsed Application form BF1/US_en_150217 Application for dispensation before a residence permit in the areas of asylum and family reunification has lapsed Use You can use this form if you hold a residence permit

More information

Tennessee Athlete Agent Application for Registration or Renewal

Tennessee Athlete Agent Application for Registration or Renewal Tre Hargett Secretary of State Tennessee Athlete Agent Application for Registration or Renewal Division of Charitable Solicitations, Fantasy Sports, and Gaming Department of State State of Tennessee 312

More information

STANISLAUS COUNTY CLERK-RECORDER APPLICATION FOR CORPORATION / PARTNERSHIP UNLAWFUL DETAINER ASSISTANT CERTIFICATE OF REGISTRATION

STANISLAUS COUNTY CLERK-RECORDER APPLICATION FOR CORPORATION / PARTNERSHIP UNLAWFUL DETAINER ASSISTANT CERTIFICATE OF REGISTRATION STANISLAUS COUNTY CLERK-RECORDER APPLICATION FOR CORPORATION / PARTNERSHIP UNLAWFUL DETAINER ASSISTANT CERTIFICATE OF REGISTRATION Filing Fees: Filing registration: $ 182.00 Each additional ID card: $

More information

ALGOMA TOWNSHIP KENT COUNTY, MICHIGAN

ALGOMA TOWNSHIP KENT COUNTY, MICHIGAN ALGOMA TOWNSHIP KENT COUNTY, MICHIGAN LICENSE APPLICATION FOR SOLICITOR, PEDDLER, AND TRANSIENT MERCHANT In accordance with Chapter 19 - Peddlers, Solicitors and Transient Merchants, of the Township of

More information

ID ACCESS BADGE APPLICATION FOR SECURED AREA/SECURITY IDENTIFICATION DISPLAY AREA (SIDA) / STERILE AREA

ID ACCESS BADGE APPLICATION FOR SECURED AREA/SECURITY IDENTIFICATION DISPLAY AREA (SIDA) / STERILE AREA ID ACCESS BADGE APPLICATION FOR SECURED AREA/SECURITY IDENTIFICATION DISPLAY AREA (SIDA) / STERILE AREA SECTION 1 TODAY S DATE: PROVIDE FULL LEGAL NAME 3880 NE 39 th Avenue, Suite A Airport Operations

More information

No. 12 of 2016 THE MINING (MINE SUPPORT SERVICES) REGULATIONS, 2017 ARRANGEMENT OF REGULATIONS

No. 12 of 2016 THE MINING (MINE SUPPORT SERVICES) REGULATIONS, 2017 ARRANGEMENT OF REGULATIONS LEGAL NOTICE NO. 151 THE MINING ACT (No. 12 of 2016) THE MINING (MINE SUPPORT SERVICES) REGULATIONS, 2017 1 Citation. 2 Interpretation. ARRANGEMENT OF REGULATIONS 3 Application of these Regulations. 4

More information

[ ]Primary Registration [ ]Secondary Registration Name of Primary County:

[ ]Primary Registration [ ]Secondary Registration Name of Primary County: County of Santa Clara Office of the County Clerk-Recorder Business Division County Government Center 70 West Hedding Street, E. Wing, 1 st Floor San Jose, CA 95110 (408) 299-5688 Space above for County

More information

Petition for Occupational Driver s License

Petition for Occupational Driver s License Ex Parte Cause No: The clerk fills out below Print your name First Middle Last District County Justice Court of: County, Texas Petition for Occupational Driver s License Print your answers: My name is:.

More information

Last Name First name Middle Initial Address DETACH HERE

Last Name First name Middle Initial Address DETACH HERE Centralized Employee Registry Reporting Form To be completed by the employer within 15 days of hire. Please print or type. EMPLOYER INFORMATION FEIN Required - - FEIN plus last 3-digit suffix used when

More information

INSTRUCTION SHEET FOR APPEAL APPLICATION UNIFORM CONSTRUCTION CODE APPEALS BOARD

INSTRUCTION SHEET FOR APPEAL APPLICATION UNIFORM CONSTRUCTION CODE APPEALS BOARD INSTRUCTION SHEET FOR APPEAL APPLICATION UNIFORM CONSTRUCTION CODE APPEALS BOARD All Uniform Construction Code appeals in Middletown Township must be submitted to the Building and Codes Department with

More information

PETITION FOR EXPUNGEMENT OF CONVICTION OR DIVERSION Pursuant to K.S.A

PETITION FOR EXPUNGEMENT OF CONVICTION OR DIVERSION Pursuant to K.S.A IN THE MUNICIPAL COURT OF MANHATTAN KANSAS CITY OF MANHATTAN vs. Case No. [Name] Petitioner Defendant PETITION FOR EXPUNGEMENT OF CONVICTION OR DIVERSION Pursuant to K.S.A. 12-4516. I respectfully request

More information

THE REQUIREMENTS FOR ALCOHOLIC BEVERAGE APPLICATION MUST BE A UNITED STATES CITIZEN ANYONE THAT OWNS 20% OR MORE OF THE BUSINESS +THE MANAGER

THE REQUIREMENTS FOR ALCOHOLIC BEVERAGE APPLICATION MUST BE A UNITED STATES CITIZEN ANYONE THAT OWNS 20% OR MORE OF THE BUSINESS +THE MANAGER THE REQUIREMENTS FOR ALCOHOLIC BEVERAGE APPLICATION MUST BE A UNITED STATES CITIZEN ANYONE THAT OWNS 20% OR MORE OF THE BUSINESS +THE MANAGER THE COST: Fingerprint record for each person (Licensee & Manager)

More information

GENERAL INSTRUCTIONS SECTION 1 APPLICANT INFORMATION. City State Zip Code Country SECTION 2 PRIMARY CONTACT INFORMATION.

GENERAL INSTRUCTIONS SECTION 1 APPLICANT INFORMATION. City State Zip Code Country SECTION 2 PRIMARY CONTACT INFORMATION. Mail completed application to: VDACS Office of Charitable & Regulatory Programs Post Office Box 526 Richmond, VA 23218 FORM 307 VDACS FINANCE CODE 988 02199 COMMONWEALTH OF VIRGINIA DEPARTMENT OF AGRICULTURE

More information

BMI-10 Account # License Type BMI 2010 Radio Group Transmissions License Agreement

BMI-10 Account # License Type BMI 2010 Radio Group Transmissions License Agreement BMI-10 Account # License Type BMI 2010 Radio Group Transmissions License Agreement AGREEMENT made between Broadcast Music, Inc. ( BMI ), located at 7 World Trade Center, 250 Greenwich Street, New York,

More information

Before the Federal Communications Commission Washington, D.C ) ) ) ) ) ) ) NOTICE OF APPARENT LIABILITY FOR FORFEITURE. Released: June 7, 2005

Before the Federal Communications Commission Washington, D.C ) ) ) ) ) ) ) NOTICE OF APPARENT LIABILITY FOR FORFEITURE. Released: June 7, 2005 Before the Federal Communications Commission Washington, D.C. 20554 In the Matter of Glenn A. Baxter RR 1 Box 776 Belgrade Lakes, ME 04918 Licensee of Amateur Radio Station K1MAN File No. EB-04-BS-111

More information

1. NAME: Last First Middle SSN: What name do you prefer to be called:? Date of Birth Place of Birth City & State. Age: Ht: Wt: Eye Color: Hair Color:

1. NAME: Last First Middle SSN: What name do you prefer to be called:? Date of Birth Place of Birth City & State. Age: Ht: Wt: Eye Color: Hair Color: STEPPING STONES MINISTRY Elmwood Avenue Church of God 1427 Elmwood Avenue Columbia, SC 29201 Telephone 803-765-9711, Ext. 207 FAX: 803-765-4555 Application for Residence Date: 1. NAME: Last First Middle

More information

Making Your Vote Count

Making Your Vote Count Making Your Vote Count LEAGUE OF WOMEN VOTERS OF MAINE EDUCATION FUND VOTING IN MAINE 1 MAINE VOTER INFORMATION Why Vote Why vote? You can help make important changes in the way your town, state, and country

More information

State of Florida Department of Business and Professional Regulation Asbestos Licensing Unit Request for Change of Status Form # DBPR ALU 4

State of Florida Department of Business and Professional Regulation Asbestos Licensing Unit Request for Change of Status Form # DBPR ALU 4 State of Florida Department of Business and Professional Regulation Asbestos Licensing Unit Request for Change of Status Form # DBPR ALU 4 1 of 15 APPLICATION CHECKLIST IMPORTANT Submit all items on the

More information

THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY Department of Criminal Justice Information Services

THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY Department of Criminal Justice Information Services THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY Department of Criminal Justice Information Services Deval L. Patrick Governor Timothy P. Murray Lieutenant Governor June

More information

EMERGENCY HEALTH SERVICES (INTERIM) REGULATION

EMERGENCY HEALTH SERVICES (INTERIM) REGULATION Province of Alberta EMERGENCY HEALTH SERVICES ACT EMERGENCY HEALTH SERVICES (INTERIM) REGULATION Alberta Regulation 76/2009 With amendments up to and including Alberta Regulation 38/2018 Office Consolidation

More information

MASSAGE/BODYWORK THERAPIST CONTINUING EDUCATION PROVIDER APPLICATION

MASSAGE/BODYWORK THERAPIST CONTINUING EDUCATION PROVIDER APPLICATION SC Dept. of Labor, Licensing and Regulation Office of Board Services Massage/Bodywork Therapy 110 Centerview Drive Post Office Box 11329 Columbia, South Carolina 29211-1329 Phone: (803) 896-4588 / Fax:

More information