FCC 606 FEDERAL COMMUNICATIONS COMMISSION Information and Instructions Approved by OMB 3060 – 0795 Est. Avg. Burden Per Response: 15 minutes Associate WTB and/or PSHSB Call Signs and Antenna Structure Registration Numbers With Licensee’s FRN 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 1 hour. Our estimate includes the time to read 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 (30600795). We will also accept your comments via the Internet if you send them to PRA@fcc.gov. 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 or if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-0795. 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://www.fcc.gov/uls (Select FCC Registration Number (FRN) Commission Registration System (CORES)) 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 FCC’s Fax Information System by dialing (202) 418-0177. In addition, all information provided in this form will be available for public inspection. If you do not provide the information we request on the form, the FCC may delay processing of your application or may return your application without action. 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. All previous editions of FCC 606 are obsolete. FCC 606 – Instructions August 2011 – Page 1 American LegalNet, Inc. www.FormsWorkFlow.com General Instructions Purpose of Form FCC Form 606 is used to associate a licensee’s FCC Registration Number (FRN) to licensee’s Wireless Telecommunications Bureau and/or Public Safety and Homeland Security Bureau call signs and antenna structure registration numbers with the Federal Communications Commission. Who Must File This Form and When All parties and entities doing business with the Wireless Telecommunications Bureau and/or Public Safety and Homeland Security Bureau must file this form to associate all call signs and antenna structure registration numbers that are not associated to licensee’s FCC Registration Number (FRN). Information Current and Complete Information filed with the FCC must be kept current and complete. If for any reason a party or entity changes their FCC Registration Number (FRN) with the Wireless Telecommunications Bureau and/or Public Safety and Homeland Security Bureau, a new FCC 606 must be submitted. Also, a new FCC 606 must be filed when adding or deleting call signs and/or antenna structure registration numbers. Paper Copies and Mailing Address The number of paper copies of this application required to be filed is one original. Filers submitting paper copies of FCC Form 606 should mail them 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. Applicable Rules and Regulations Filers should refer to the Debt Collection Improvement Act of 1996. The Debt Collection Act requires all federal agencies to ensure that no debtors to the Federal government receive refunded monies. To ensure this, the FCC must collect FRN information to correlate its filers with any outstanding Federal debt that they might have incurred in other dealings with the Federal government. For Assistance For assistance with this application, contact the Federal Communications Commission, 1270 Fairfield Road, Gettysburg, PA 17325-7245, call (877) 480-3201 (TTY 717-338-2824) or visit the web at http://esupport.fcc.gov. Electronic Filers For assistance with filing electronically, contact the FCC’s ULS homepage @ http://wireless.fcc.gov/uls or contact the FCC at (877) 4803201. Instructions for Main Form Licensee/Antenna Structure Owner Information Item 1 This item is mandatory. 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 (Select FCC Registration Number (FRN) Commission Registration System (CORES)) 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 the FCC’s Fax Information System by dialing (202) 418-0177. Items 2-11 These items identify the person or entity that has registered the FRN and call signs/registration numbers. Items 2-9 must be completed; Items 10 and 11 (FAX and E-Mail) are optional. Complete either Item 2 (Name) or Item 3 (Entity Name), depending on whether the licensee is an individual or an entity, respectively. You may enter a post office box number in Item 4 or a street address in Item 5, or enter information for both items. Associate Valid Call Signs or Antenna Structure Registration Numbers Items 12 & 13 Licensees should list all valid Wireless Telecommunications Bureau and/or Public Safety and Homeland Security Bureau call signs associated with the FCC Registration Number entered in Item 1 & antenna structure owners should list all valid antenna structure registration numbers associated with the FCC Registration Number entered in Item 1. FCC 606 – Instructions August 2011 – Page 2 American LegalNet, Inc. www.FormsWorkFlow.com FCC 606 Main Form Approved by OMB Associate WTB and/or PSHSB Call Signs and Antenna Structure Registration Numbers With Licensee’s FRN 3060-0795 See instructions for Public burden estimate Licensee/Antenna Structure Owner Information 1) FCC Registration Number (FRN) (10 digits): 2) First Name (if individual): MI: Last Name: Suffix: 3) Entity Name (if other than individual): 4) P.O. Box: 6) City: 9) Telephone Number: And /Or 5) Street Address: 7) State: 8) ZIP Code: 10) FAX Number: 11) E-Mail Address: 12) Valid Wireless Telecommunications Bureau and/or Public Safety and Homeland Security Bureau Call Signs (attach additional sheets if necessary) 13) Valid Wireless Telecommunications Bureau and/or Public Safety and Homeland Security Bureau Antenna Structure Registration Numbers (attach additional sheets if necessary) FCC 606 – Main Form August 2011 – Page 1 American LegalNet, Inc. www.FormsWorkFlow.com