FCC Grantee Registration

Upon completion of this filing, you will receive a five-character Grantee Code to be used when completing the FCC Form 731, Application for Equipment Authorization (there will be no digits zero and/or one in the Code). Please retain this Code for future reference. After successful completion of the Grantee Registration, you will be presented with the Fee Remittance Advice, FCC Form 159. The Form 159 may be submitted electronically (at least 128-bit encryption is required) or in paper form, along with payment to: Federal Communications Commission, Equipment Approval Services, P. O. Box 358315, Pittsburgh, PA 15251-5315.

Grantee's FCC Registration Number(FRN): *

Grantee's Complete, Legal Business Name: *

Grantee's Mailing Address (* Either line one or P.O. Box is required):

Line 1: *

Line 2:

P.O. Box:

City: *

State:

Country: *

Zip/Postal Code:

Grantee's Contact Information

First Name: *

Middle Name:

Last Name: *

Title:

Telephone Number: *	Extension:

Fax Number: *

E-mail: *

Mail Stop:

By clicking the proceed button you certify that you are authorized to enter or request changes to this grantee code. All of the statements herein and the exhibits attached hereto, are true and correct to the best of your knowledge and belief. Note that a grantee may authorize an agent to act on his / her behalf in making changes; however, the grantee remains responsible for all grantee information.

* - Indicates that this field must be completed before the registration can be submitted

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