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610instr.txt
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1994-11-27
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UNITED STATES of AMERICA
FEDERAL COMMUNICATIONS COMMISSION
1270 FAIRFIELD ROAD
GETTYSBURG, PENNSYLVANIA 17325-7245
TELEPHONE (717) 337-1212
INSTRUCTIONS FOR APPLICATION FORM 610 FOR AMATEUR OPERATOR/PRIMARY
STATION LICENSE
(Do Not Return Instructions With Application Form)
GENERAL INSTRUCTIONS
* Use the attached FCC Form 610 to request:
1. An examination for a new amateur operator/primary station license
or for modification of your license to a higher operator class.
2 A modification of your name or mailing address as it appears on your
license, or a systematic assignment of a different call sign.
3. A renewal of your license if it is unexpired or if it expired within
the two year grace period.
* Do NOT use the attached FCC Form 610 to request:
1. A Reciprocal Permit for Alien Amateur Licensee. Use FCC Form 610 A.
2. A renewal or modification of a club, military recreation, or RACES
station license. Use FCC Form 610 B.
* ANTENNA HEIGHT: If the height of your antenna will exceed 61 meters
(200 feet) or 1/100 of the minimum distance between the antenna site
and any aircraft landing area (refer to Section 97.15) complete FCC
Form 854 (Request for Antenna Height Clearance and Obstruction Marking
and Lighting Specifications). Forms may be obtained from the
Commission's Form Distribution Center, phone (202) 632-FORM.
* If you have not received a response from us within 90 days, write to
Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA
17325-7245. Include a photocopy of your completed FCC Form 610, or the
following information:
1. Your name, address, and date of birth;
2. Your station call sign and operator class;
3. The date that you filed FCC Form 610;
4. The purpose of the FCC Form 610 you filed;
5. The name of the coordinating VEC;
6. The location of the test site (city and state) and
the date of the examination.
* Every amateur operator should have a current copy of the amateur
service rules, Part 97, which may be obtained from private publishers,
vendors, or you may order 47 CFR, Part 80 to End from the U. S.
Government Printing Office, Washington, DC 20402, phone (202) 783-3238.
* Detach your completed FCC Form 610 from these instructions. Make a
photocopy of it for your records. File your completed FCC Form 610 with
the VEs if you have marked Box 4A or 4B on the application. If you have
marked box(es) 4C through 4F, mail FCC Form 610 WITHOUT A FEE to:
FEDERAL COMMUNICATIONS COMMISSION
1270 FAIRFIELD RD
GETTYSBURG PA 17325-7245
INSTRUCTIONS TO EXAMINEE
A. Your examination will be administered at a location and time
specified by your administering VEs. You must comply with their
instructions. The VEs will observe you throughout the examination.
They are responsible for the proper conduct and necessary supervision
of the examination. They must immediately terminate the examination
if you fail to comply with their instructions.
B. If you hold an unexpired license, or if you hold a license that
expired less than two years before the date of the examination
session, attach a photocopy of it, or the original, to the
application.
C. Give your completed FCC Form 610 to your administering VEs. Show
your VEs at least two documents that prove your identity. Show your
VEs any of the following documents for which you are claiming
element credit:
1. Original document of your unexpired (or expired within the grace
period) amateur operator/primary station license;
2. Certificate(s) of Successful Completion of Examination, if issued
to you within 365 days of this examination session;
3. Photocopy of FCC Form 610 that was filed indicating that you
qualified for a Novice Class operator license within 365 days of this
examination session;
4. Original document of your unexpired (or expired less than five
years prior to this examination session) FCC Commercial
Radiotelegraph Operator's Certificate.
INSTRUCTIONS TO PERSONS WITH SEVERE HANDICAPS
A. If you have passed the 5 words per minute telegraphy examination,
but you are unable to pass the 13 or 20 words per minute examination
because of a severe handicap that will extend for more than 365 days,
the administering VEs will give you credit for passing the 20 words
per minute examination if you obtain a Physician's Certification of
Disability. You should, however, first attempt to pass the examination
under the special accommodative procedures the VEs use for handicapped
examinees.
B. Detailed Instructions:
1. Complete Items 1 through 9 on FCC Form 610.
2. Present your physician with your completed FCC Form 610 and the
Notice to Physician Certifying to a Disability.
3. Provide the physician with the names and addresses of your
administering VEs and other amateur operators in your community who
can provide more information on this matter.
4. Ask your physician to complete and sign the Physician s
Certification of Disability in Section 3 of FCC Form 610.
5. Sign and date the Patient's Release in Section 3 of FCC Form 610.
6. Follow Instructions to Examinee.
FCC Form 610-instructions
November 1993
INSTRUCTIONS FOR COMPLETING APPLICATION FORM 610
ITEM 1 - Print (or type) your last name and any suffix (Jr., Sr.,
II, etc.), first name, and middle initial. The name you enter in
item 1 must agree with your signature in Item 8. It must also agree
with the name on your existing license unless you request a change
in Box 4C.
ITEM 2 - Print numbers for the month, day, and year of your birth.
Example: If you were born on September 20, 1944, enter 09-20-44.
ITEM 3 - Print your mailing address. It must be an address where you
can receive mail delivered by the United States Postal Service. (Mail
delivery may not be available in certain territories.) Print your
two-letter state/territory code from the table. For Midway Island,
print its full name in the city box.
Alabama AL
Alaska AK
Arizona AZ
Arkansas AR
California CA
Colorado CO
Connecticut CT
Delaware DE
District of Columbia DC
Florida FL
Georgia GA
Hawaii HI
Idaho ID
Illinois IL
Indiana IN
Iowa IA
Kansas KS
Kentucky KY
Louisiana LA
Maine ME
Maryland MD
Massachusetts MA
Michigan MI
Minnesota MN
Mississippi MS
Missouri MO
Montana MT
Nebraska NE
Nevada NV
New Hampshire NH
New Jersey NJ
New Mexico NM
New York NY
North Carolina NC
North Dakota ND
Ohio OH
Oklahoma OK
Oregon OR
Pennsylvania PA
Rhode Island RI
South Carolina SC
South Dakota SD
Tennessee TN
Texas TX
Utah UT
Vermont VT
Virginia VA
Washington WA
West Virginia WV
Wisconsin WI
Wyoming WY
American Samoa AS
Guam GU
Midway Island UM
Northern Mariana Is MP
Puerto Rico PR
Virgin Islands VI
ITEM 4 - Place an "X" in the proper box to apply for:
BOX 4A An EXAMINATION for a new amateur operator/primary station
license. See Instructions to Examinee on reverse. You are eligible
for an examination for a new license if you do not have one or if
your license has expired beyond the two year grace period.
BOX 4B An EXAMINATION to upgrade your license to a higher class.
See Instructions to Examinee on reverse.
BOX 4C CHANGE your name as it appears on your license to your new
name in Item 1. Print your former name where indicated.
BOX 4D CHANGE your mailing address as it appears on your license to
your new address in Item 3.
BOX 4E CHANGE your station call sign. See Fact Sheet PR-5000, Number
206, Amateur Station Call Sign Assignment System, latest date of
issue, for information on how the call sign will be systematically
assigned. After the call sign change is made, your previous call sign
cannot be reinstated. Initial in the space provided.
BOX 4F RENEWAL of your unexpired license or RENEWAL of your license
if it expired within the grace period. The expiration date must be
within the two year grace period. Application must be received by the
Commission's Gettysburg office prior to the end of the grace period.
ITEM 5 - If your license document was lost or destroyed, attach to
your FCC Form 610 a sheet of paper containing your explanation.
ITEM 5A - Print the call sign shown on your license.
ITEM 5B - Print the operator class shown on your license.
ITEM 6 - If the construction of your station would be an action that
is likely to have a significant environmental effect, mark "Yes" and
attach to your FCC Form 610 an environmental assessment. Otherwise,
mark "No". See the Commission's Rules, 47 C.F.R., Part l, Subpart I,
and Section 97.13 (a).
ITEM 7 - If you have filed another Form 610 that we have not acted
upon, give the purpose of the other form in Box 7A and print the
month, day, and year it was filed in Box 7B.
ITEM 8 - Sign your name. Your signature must agree with your name
as printed in Item 1.
ITEM 9 - Print the month, day, and year that you sign your application.
Public reporting burden for this collection of information is
estimated to average ten minutes per response, including the time
for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding
this burden estimate or any other aspect of this collection of
information, including suggestions for reducing the burden to the
Federal Communications Commission, Records Management Division,
AMD-PIRS, Washington, DC 20554, and to the Office of Management and
Budget, Paperwork Reduction Project (3060-0003) Washington, DC 20503.
NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT OF 1974 AND THE
PAPERWORK REDUCTION ACT OF 1980
The solicitation of personal information requested in this form
is authorized by the Communications Act of 1934, as amended.
The Commission will use the information provided in this form)
to determine whether grant of this application is in the public
interest. In reaching that decision, or for law enforcement
purposes, it may become necessary to refer personal information
contained in this form to another government agency. In addition,
all information provided in this form. as well as the form itself,
will be available for public inspection. If information requested
on the form is not provided, processing of the application may be
delayed or the application may be returned without action pursuant
to Commission rules. The foregoing notice is required by the
Privacy Act of 1974, 5 U.S.C. Section 522a(e)(3).
FCC Form 610 Instructions
November 1993