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FCC 605

Schedule for Additional Data for the

Approved by OMB

Ship Radio Service (Part 80)

Schedule B

3060 - 0850

See 605 Main Form Instructions

for public burden estimate

You must obtain an FCC Ship Radio Station License if: (1) you are required by law or treaty to carry a radio on your vessel; (2) your vessel travels to

foreign ports; (3) you use marine radio equipment on board your vessel other than marine VHF radios, EPIRBs (Emergency Position Indicating Radio

Beacon), and radar. If you are not required to obtain a license -- you do not need to file this form with the FCC.

1) Type of License: (

) Regular Portable

Fleet If Fleet, give number of ships in fleet:

2) Class of Ship: (enter one code for each) General Class of Ship: _____________Specific Class of Ship: _____________

3) If application is for a new authorization and the ship already has a four letter call sign, enter it here: __ __ __ __

Other Required Information

4) Name of ship:

5) Official Number of ship (Coast Guard Documentation No. or State Registration No.):

6) Will ship make international voyages?

(

) Yes No

7) Will ship communicate with foreign coast stations?

(

) Yes No

Complete items 8-10 only if you have Radiotelegraph, Narrow-band Direct-printing (NB-DP)/SITOR, or Digital Selective Calling

Equipment. Check each box that applies and provide information as needed.

8) I have Radiotelegraph (2000-27500 KHz) on my vessel and the FCC has not yet assigned a Morse working series to my vessel.

9) I have Digital Selective Calling (DSC) equipment and/or Radiotelegraph NB-DP and need a new 9 digit Maritime Mobile Service Identity

(MMSI). Do not check this box if you already have been assigned a 9 digit MMSI by the FCC or received a 9 digit MMSI by

commissioning an INMARSAT B, C, or M terminal through COMSAT/Lockheed Martin.

Note: The single MMSI assigned by the FCC or issued by COMSAT/Lockheed Martin or Stratos should be used with all DSC radio

equipment and INMARSAT B, C, or M terminals on board your vessel.

10) If already assigned, my MMSI Number is:

Complete items 11 and 12 only if vessel is required by law or treaty to carry radio equipment.

11) Ship Radio Requirement Categories

(A) RADIOTELEGRAPH STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT

(B) RADIOTELEPHONE STATION REQUIRED BY TITLE III, PART II OF THE COMMUNICATIONS ACT OR SAFETY CONVENTION

(D) RADIOTELEPHONE STATION REQU IRED BY GREAT LAKES RADIO AGREEMENT

(E) RADIOTELEPHONE STATION REQUIRED BY THE VESSEL BRIDGE-TO-BRIDGE RADIOTELEPHONE ACT

12) Ship Information

Gross Tonnage:

Length (in meters):

Ship Radio Station License Certification Statement

Applicant certifies that they are the owner or operator of the vessel, a subsidiary communications corporation of the owner or operator of the vessel, a

state or local government subdivision, or an agency of the US Government subject to Section 301 of the Communications Act.

FCC 605 - Schedule B

July 2002 - Page