FCC - License Renewal Application -

FCC LICENSE

RENEWAL APPLICATION
** indicates mandatory fields to fill out
1. **Company Name/DBA as it should appear on license
**Mandatory Field
**FRN# can be found on your current License
2. **Applicant is: (must check one)

Corporation/LLCIndividualPartnershipGovernment EntityOther
3. **Mailing Address to be used on license/application

Street Address

Street Address Line 2

CityState

Zip Code
3a. **Email Address
example@example.com
4. WS Communications Contact
5. **Name of Contact Person on license
5a. **Contacts Phone Number
6. Type of RADIO SERVICE: Business
7. Call Sign (on License)
**Typed or Printed Name of Party Authorized to Sign:
**Name

First NameMiddle InitialLast Name
Title
**Signature

Clear
**Date

MonthDayYear
Date
FAILURE TO SIGN THIS APPLICATION MAY RESULT IN DISMISSAL OF THE APPLICATION AND FORFEITURE OF ANY FEES PAID.

Upon grant of this license application, the Licensee may be subject to certain construction or coverage requirements. Failure to meet the construction or coverage requirements will result in termination of the license. Consult appropriate FCC regulations to determine the construction or coverage requirements that apply to the type of license requested in this application.

WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE

AND/OR IMPRISONMENT (U.S. Code, Title 18, § 1001) AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Title 47, § 312(a1, AND/OR FORFEITURE (U.S. Code, Title47,§ 503
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