Section 2: FCC Form 312EZ Technical Summary
 

Overview

When you have completed the EZ qualification questions, and it has been determined that you qualify for an EZ, you will be prompted to enter the technical data relevant to your filing.

For a guide to required vs. non-required technical data fields associated with the Site, Antenna, Frequency, and Frequency Coordination Tabs, please see the Matrix at the end of this document.

Reminder: You can save the information that you have already entered and exit the EZ form at any time throughout the filing process.

Menu Options

An Application Tools box containing menu options is displayed immediately above the tabs in the Technical Data Section.  Menu options allow you to select an action to be performed on your application, or on one or more rows of data within your application.  They include the following:  File, Save, Finalize, Update Applicant FRN, Update Contact FRN, Route, Routing History, Print Preview Application, Print Preview App & Attachments, and Print Preview Tab.  

To perform one of these actions on an application, select the action from the Menu Bar. The valid options available to you will vary depending on the tab that you currently have selected.  

 Qualifications Tab 

The Qualifications Tab contains each EZ qualification question and your response to the question. 

Administrative Info Tab 

Based on the information entered in CORES for the applicant and contact/attorney of record, the system prefills the applicant and contact/attorney of record information from the FRN.

The fields Attn Phone, Attn Fax, Attn Email, and Attention will be editable.

The fields Contact Attn Name, Contact Attn Phone, Contact Attn Fax, and Contact Attn Email, will be editable.

Applicant

  • FRN

  • Contact Name

  • Company Name

  • Street 1

  • Street 2

  • City

  • State

  • Zip Code

  • Corporate Phone

  • Corporate Fax

  • Corporate E-mail

  • Attn Phone

  • Attn  Fax

  • Attn  Email

  • Attention

Contact/Attorney of Record

  • FRN

  • Contact Name

  • Company

  • Street 1

  • Street 2

  • City

  • State

  • Zip

  • Corp. Phone

  • Corp. Fax

  • Corp. E-mail

  • Contact Attn 

  • Contact Attn  Phone

  • Contact Attn  Fax

  • Contact Attn Email

 

Station Info Tab

Call Sign 

The call sign is generated by the system.  You will not be allowed to change this information.  

Nature of Service 

This information is prefilled with Fixed Satellite Service, because you selected either Fixed or Temporary Fixed in qualification question #2.  You will not be allowed to change this selection.

 Status

You must select at least one or both of the following: Common Carrier; Non Common Carrier.

 Satellite Orbit Type 

This information is prefilled with GSO because you answered Yes to the Satellite qualification question #5.  You will not be allowed to change this selection.

 Class of Earth Station

This information is prefilled with either Fixed Earth Station or Temporary Fixed Earth Station, because you selected either Fixed or Temporary Fixed in qualification question #2.  You will not be allowed to change this selection. 

 Filing Classification 

This information is prefilled with one of the following filing classifications: Application for License of New Station or Domestic Receive Only Earth Station.  This is based on your answers to the EZ qualification question #12.  You will not be allowed to change this selection.

 Satellite Name

 This information is prefilled with Permitted List if you answered Yes to the Satellite qualification question # 5.  You will not be allowed to change this selection.

 Frequency Band(s)

 This information is prefilled based on your response to the Bands qualification question #3.  If you will be operating in the KU band, this field will be prefilled with Ku Band.  If you will be operating in the C band, this field will be prefilled with C Band.  You will not be allowed to change this selection.

Type of Facility

If you answered Receive Only to qualification question #12, the type of facility will be prefilled with Receive Only. (Receive Only refers to “registration” – not “license.”  (Applicants who seek Receive Only Licenses to communicate with foreign satellites not on the Permitted List must apply for a license on a 312 Main Form.)  If you answered Transmit Only or Transmit/Receive to qualification question #12, the type of facility will be prefilled with either Transmit Only or Transmit/Receive.  You will not be allowed to change this selection. 

 PN Description

You must enter a full Description for this application.  This information is required in order to submit your application.  This information will appear on the Public Notice.  Descriptions such as “See Attachment” are not acceptable.  Please limit your description to 500 characters.

Completed Construction Date (The required date for completion of construction).

 The completed construction date field appears only when the application has been granted.  You cannot edit this information.

Required Construction Date

The required construction date field appears only when the application has been granted.  You cannot edit this information. 

Commencement of Operation Date

The commencement of operation date field appears only when the application has been granted.  You cannot edit this information. 

Point of Communication Tab

Points of Communication (B2) 

You will not be able to access the Points of Communication Tab until you have entered and saved the Site ID on the Site Tab.  You must select the Site ID from that entered on the Site Tab.  You cannot change the Site ID from the Points of Communication Tab.  Points of Communication is prefilled with Permitted List based on a Yes response to the qualification question #5.  You cannot edit this field.

Site Tab

Site ID (B1B)

The Site ID is the ID given to the site by the applicant.  You can enter up to 20 alphanumeric characters for the Site ID.  This information is required once you are on the site tab and must be specified before any other site information can be saved.  It is also required in order to enter any Antenna information on the Antenna Tab.   

Contact Phone (B1C)

Telephone number for the earth station.  Enter numeric values using the following format: nnn-nnn-nnnn (extension).   

Street Address of Station (B1D)

Street (1 & 2) address of the earth station.  You can enter up to 40 alphanumeric characters for each line item street address. 

Area of Operation (B1D)

Geographical location of the earth station  

Contact Name (B1E)

Name of the person to be contacted in case of emergency, including reports of interference, to implement corrective measures.  You may enter up to 40 alphabetic characters for the site’s contact person. 

City (B1F) 

City in which the earth station is located.  You may enter up to 20 alphabetic characters for the city. 

 County (B1G)

County in which the earth station is located.  You may enter up to 22 alphabetic characters for the county.  

State (B1H)                                                  

State code for the state in which the earth station is located.  You will select a two-letter state code from drop down list of US states. 

Zip Code (B1I)

Mailing address zip code for the earth station.  You may enter five numeric values or the entire zip code using the following format: nnnnn or nnnnn-nnnn. 

Geographic Coordinates – Latitude (º) (B1Ji) 

Geographic Coordinates - Latitude (º) pertains to the degrees part of the geographic latitude of the station location.  Enter numeric values only using the following format: dd.  The valid range is 0 to 90 degrees. 

Geographic Coordinates – Latitude (º) (B1Jii) 

Geographic Coordinates - Latitude (’) pertains to the minutes part of the geographic latitude of the station location.  Enter numeric values only using the following format: mm.  The valid range is 0 to 59 minutes. 

 Geographic Coordinates – Latitude (”) (B1Jiii)

 Geographic Coordinates - Latitude (”) pertains to the seconds part of the geographic latitude of the station location.  Enter numeric values only using the following format: ss.ss.  The valid range is 0 to 59.99 second

Geographic Coordinates – Latitude (hemi) (B1Jiv)

Geographic Coordinates - Latitude (hemi) pertains to the hemisphere indicator for the geographic latitude of the station location.  You can select N (North) or S (South) from the drop down. 

Geographic Coordinates – Longitude (º) (B1Jv)

 Geographic Coordinates - Longitude (º) pertains to the degrees part of the geographic longitude of the station location.  Enter numeric values only using the following format: ddd.  The valid range is 0 to 180 degrees. 

 Geographic Coordinates – Longitude (’)) (B1Jvi)

 Geographic Coordinates - Longitude (’) pertains to the minutes part of the geographic longitude of the station location.  Enter numeric values only using the following format: mm.  The valid range is 0 to 59 minutes.  For Fixed earth stations, this information is required in order to submit your application.  For Temporary fixed earth stations, this field is not needed and is grayed out

 Geographic Coordinates – Longitude (”) (B1Jvii)

 Geographic Coordinates - Longitude (”) pertains to the seconds part of the geographic longitude of the station location.  Enter numeric values only using the following format: ss.ss.  The valid range is 0 to 59.99 seconds. 

 Geographic Coordinates – Longitude (hemi) (B1Jviii)

Geographic Coordinates - Longitude (hemi) pertains to the hemisphere indicator for the geographic longitude of the station location.  You may select E (East) or W (West) from the drop down. 

 Latitude/Longitude Coordinates are: (B1K)

 Indicates whether the site coordinates entered are based on NAD 27 or NAD 83.  You may select NAD 83 or NAD 27, but not both.

Site Elevation (AMSL) (B1L)

Site Elevation pertains to the ground level of the site, rounded off to the nearest tenth of a meter, upon which the antenna will be constructed, above mean sea level.  Enter numeric values with one decimal place.  An example of a valid format is 250.0 meters.  The valid range is -100 <= x <=+6200 meters.   

Antenna Tab

Site ID (B4A) 

The Site ID is the ID given to the site by the applicant.  This information is prefilled with the Site ID entered on Site Tab.   

Antenna ID (B4B)

The ID entered for the antenna on the application.  The antenna ID consists of up to 10 alphanumeric characters. .  The antenna ID must be specified before any other antenna information can be saved.  This information is required once you are on the Antenna Tab, and must be specified in order to enter any Frequency or Frequency Co-ordination information.  Only one antenna is allowed per EZ filing. 

Quantity (B4C)

The Quantity pertains to the number of this model antenna used at the earth station.  Only one antenna is allowed for EZ filings; therefore, the quantity is prefilled with 1.  You cannot edit this information. 

Manufacturer (B4D)

Name of the manufacturer of the antenna.  You may enter up to 40 alphabetic characters. 

Model (B4E)

The manufacturer product Model number for the antenna.  You may enter up to 20 alphanumeric characters. 

Antenna Size (meters) (B4F)

Diameter of the earth station antenna in meters.  Enter numeric values of the diameter only using the following format nn.nn.  For C Band (3700 to 4200 MHz and 5925 to 6425MHz), diameter must be equal to or greater than 04.50 meters.  For Ku Band, (11700 MHz to 12200MHz and 14000MHz to 14500MHz), diameter must be equal to or greater than 01.20 meters. 

T/R Mode.  Prefilled with T and/or R depending on your response to qualification question #3.  You cannot edit this field.

Antenna Gain Transmit and/or Receive dBi (B4Gi)

Transmit Antenna gain (dBi) at reference frequency.  Enter numeric values only using the following format nn.nn (Receive dBi).  When the application is finalized, data entered will be checked against the result of the Antenna gain Formula.  Your antenna manufacturer should be able to give you the antenna gain for the antenna in accordance with the formula shown herein.    If you, the user, must calculate antenna gain don’t forget to convert units such as GHz and MHz to Hz. 

Formula:

 G0 = 10 log10[ h (p Df/c )2 ]

Where:

G0 = the maximum on-axis antenna gain in dBi

h = antenna efficiency (acceptable range is from  10% to 100%(h = 0.1to h =1.0)

p = 3.14159… (pi), ( to 7 dps)

D = antenna diameter (meters),

c = speed of light, 3 x 108 meters/sec, and

f = reference frequency (Hz) .

at < Freq> GHz (B4Gii)

The reference frequency at which Antenna Gain is measured. Enter numeric values only using the following format nnn.nnnn .  This information is required in order to submit your application. 

For C band, frequencies entered must be between 3.700 and 4.200, downlink, or 5.925 and 6.425, uplink.  For Ku Band, frequencies entered must be between 11.700 and 12.200, downlink, or 14.000 and 14.500, uplink. 

Antenna Structure Registration (ASR) No (B5B)

Registration number of the antenna structure in FCC ASR database.  The ASR number consists of 10 numeric characters.  This information is required in order to submit your application if you answered “Yes” to the ASR qualification question #10.  Upon entry, the system validates the number you entered against the FCC ASR database and checks that the status associated with that number is “Constructed”.  If ASR fails validation, the system will display the reason for failure.  You will be prompted to enter a valid ASR.  The system will provide a link to the ASR search screen to enable you to search for a valid ASR number.

Maximum Antenna Height Above Ground Level (meters) (B5C)

Maximum height above ground level (AGL), in meters, to the top of the antenna structure.  The valid range is -50 to 150 meters above ground level.  Enter numeric values only.  Please see Part 17 of the FCC Rules & the Wireless Telecommunications Bureau Fact Sheet.

Maximum Antenna Height Above Mean Sea Level (meters) (B5D)

Maximum height above mean sea level in meters.  Enter numeric values only.  The valid range is -86 m <= Height AMSL <= 6194 m. 

Structure Height Above Ground Level (meters) (B5E)

Building height above ground level on top of which this antenna is situated.  Enter numeric values only – expressed in meters.  The valid range is 0 - 500 meters

Maximum Antenna Height above Rooftop (meters) (B5F)

Maximum height of this antenna above the building rooftop.  The maximum value is 6.1 meters.  Enter numeric values only.  Please see Part 17 of the of the FCC Rules & the Wireless Telecommunications Bureau Fact Sheet on Antenna Structure Registration

Total Input Power at Antenna Flange (Watts) (B5G)

Maximum authorized power into the flange of the antenna for all carriers.  Enter numeric values only using the following format: nnnn.nn.  Values entered may not exceed 450 watts for C band; 500 watts for Ku Band.   

Total EIRP for All Carriers (dBW) (B5H)

Maximum authorized composite output EIRP from all emissions transmitted from the antenna.  Enter numeric values only using the following format: nnn.nn.  The value entered here should be greater than or equal to the largest value provided in max EIRP per Carrier. If the value is invalid, the following error message will display “Total EIRP for all Carriers should be greater than largest value specified in Max EIRP per carrier.”

EIRP

Effective Isotropic Radiated Power (EIRP) is defined as an equivalent transmit power and is expressed mathematically as:

EIRP = Pr At

where

EIRP = effective isotropic radiated power (watts)

Pr = total power radiated from an antenna (watts)

At = transmit antenna gain (dBi)

Expressed as a log 

EIRP (dBW) = Pr (dBW) + At (dBi) 

Frequency Tab

Antenna ID (B7A)

This field shall be prefilled with the data entered in Antenna ID.  This field is not editable.

Frequency Lower (MHz) (B7B)

Lower frequency limit of the frequency band to which this emission is limited. 

For C Band, value entered should be either 3.700 and 4.200 GHz or 5.925 and 6.425 GHz, or 3700 and 4200 MHz or 5925 and 6425 MHz.

For Ku band, value entered should be either 11.700 and 12.200 GHz or 14.000 and 14.500 GHz, or 11700 and 12200 MHz or 14000 and 14500 MHz. 

Frequency Upper (MHz/GHz) (B7B)

Upper frequency range limit of the frequency band to which this emission is limited. 

For C Band, value entered should be either 3.700 and 4.200 GHz or 5.925 and 6.425 GHz, or 3700 and 4200 MHz or 5925 and 6425 MHz.

For Ku band, value entered should be either 11.700 and 12.200 GHz or 14.000 and 14.500 GHz or 11700 and 12200 MHz or 14000 and 14500 MHz.

T/R Mode (B7C)

A single letter code to indicate the transmission mode: T=Transmit, R=Receive.  You may select either T or R.  If  the upper and lower frequencies are 3.700 and 4.200 GHz or 11.700 and 12.200 GHz; the T/R Mode is prefilled with R; otherwise it is prefilled with T. 

Polarization (B7D)

Polarization type authorized for the associated frequency range and emission.  You must select (H)orizontal, (V)ertical, or (H/V) Horizontal and Vertical.  .

Emission Designator (B7E)

The emission designator pertains to the emission designator or descriptor for the carrier being transmitted or received.  This emission descriptor is composed of two parts, (1) the bandwidth of the emission, and (2) the classification of the emission.  Click on emission designator for guidelines on entering the emission designator.

(Link to Section 2.201 of the rules.)

Maximum EIRP per Carrier (dBW) (B7F) 

For C Band Transmit Antenna Gain will be the gain entered at a frequency value between 5.925 and 6.425 GHz.  For KU Band Transmit Antenna Gain will be any gain measured at a frequency value between 14 and 14.5 GHz. 

Based on values entered by user in Total Input Power at Antenna flange, and Antenna Gain, calculate Maximum EIRP per carrier as follows:  Maximum EIRP per Carrier <= 10 x Log 10 (Total Input Power at Antenna flange (watts)) + Transmit Antenna Gain (in dBi)).

Maximum EIRP Density per Carrier (dBW/4kHz) (B7G) 

Maximum effective isotropically radiated power density over the worst 4 kHz band for the associated emission and frequency value/range.  Enter numeric values expressed in dBW/4kHz.  If the value you entered is invalid, the following message displays, “Maximum Input power density exceeds value allowed on the EZ.”

 C-BAND

In the 3700-4200 MHz band:

 Antenna diameter(from B4F) >= 4.5 meter         ‘Citation = §25.209(c)

 In the 5925-6425 MHz band:

 Antenna diameter(from B4F)  >= 4.5 meter       ‘Citation = §25.209(a); §25.209(c)

Transmit/Receive Mode = “T” 

IF( Antenna diameter >= 4.5 meter AND “full transponder services”[1]) THEN   ‘

          Max. power into the antenna <= 450 watts Citation = §25.211(d)

 IF( Antenna diameter >= 4.5 meter AND modulation = “ANALOG”[2]                  ‘

          AND bandwidth <= 200 kHz) THEN

          Max. power density into the antenna <= +0.5 dBW/4kHz Citation = §25.212(d)

 IF( Antenna diameter >= 4.5 meter AND modulation = “DIGITAL” ) THEN      

            Max. power density into the antenna <= -2.7 dBW/4kHz Citation = §25.212(d)

Ku-BAND

In the 11700-12200 MHz band:

[[1] “Full transponder services” in §25.211(d) is not defined. An interpretation that has been used by the staff is any transmission with a bandwidth greater than or equal to 25 MHz.  The emission designator must be examined to determine the bandwidth of the emission.

[2] The emission designator must be examined to determine whether the transmission is “analog” or “digital”.

[1] Same as for C-Band “full transponder services”.

Antenna diameter >= 1.2 meter              ‘Citation = §25.209(a); 25.209(g)

 Transmit/Receive Mode = “R”               

In the 14000-14500 MHz band:

Antenna diameter >= 1.2 meter              ‘Citation = §25.209(a); 25.209(g)

 Transmit/Receive Mode = “T”               

IF( Antenna diameter >= 1.2 meter AND “full transponder services”[1]) THEN     

            Max. power into the antenna <= 500 watts Citation = §25.211(d)

‘IF( Antenna diameter >= 1.2 meter AND modulation = “ANALOG”[2]                  ‘

            AND bandwidth <= 200 kHz) THEN

            Max. power density into the antenna <= -8.0 dBW/4kHz Citation = §25.212(c)

IF( Antenna diameter >= 1.2 meter AND modulation = “DIGITAL” ) THEN       ‘

            Max. power density into the antenna <= -14 dBW/4kHz Citation = §25.212(c)

Modulation and Services (B7H)

Description of the modulation and services for this frequency/emission. You may enter up to 255 characters for the description. 

Frequency Coordination Tab

Antenna ID (B6A)

Id entered for the antenna on the application.  This information is prefilled. 

Trans/Rec Mode

Indicates the transmission mode: Transmit, Receive. 

Lower Frequency Limit (MHz) (B6Bi)

Lower frequency limit in MHz over which the station has been frequency coordinated with the terrestrial facilities that share the same frequency band.  Enter numeric values only.  For C Band, value entered should be between 3700 and 4200 or 5925 and 6425.  For Ku band value entered should be between 11700 and 12200 or 14000 and 14500.   

Upper Frequency Limit (MHz) (B6Bii)

Upper frequency limit in MHz over which the station has been frequency coordinated with the terrestrial facilities that share the same frequency band.  Enter numeric values only.  For C Band, value entered should be between 3700and 4200 or 5925 and 6425.  For Ku band values entered should be between 11700 and 12200 or 14000 and 14500. 

[1] Same as for C-Band “full transponder services”.

[2] The emission designator must be examined to determine whether the transmission is “analog” or “digital”.

Range of Satellite Arc Eastern Limit (B6C)

Identifies the eastern limit of satellite orbital arc, to the tenth of a degree, over which the earth station has been coordinated to operate in the designated frequency band.  East longitude is positive.  Enter numeric values only using the following format: nnn.n.  The valid range is 0 to 180. 

Range of Satellite Arc Eastern Limit (hemi) (B6Ci) 

Identifies the hemisphere of the eastern limit of satellite orbital arc over which the earth station has been coordinated to operate in the designated frequency band.  This information is prefilled with “W.” The field is editable; “E” is also permitted.  If the value you entered is invalid, the following message displays, “You must fill this field with either ‘E’ or ‘W,’ depending on the hemisphere in which the satellite is located.”

Range of Satellite Arc Western Limit (B6D)

Identifies the western limit of satellite orbital arc, to the tenth of a degree, over which the earth station has been coordinated to operate in the designated frequency band.  West longitude is positive.  Enter numeric values only using the following format: ddd.  The valid range is 0 to 180. 

Range of Satellite Arc Western Limit (hemi) (B6Di) 

Identifies the hemisphere of the western limit of satellite orbital arc over which the earth station has been coordinated to operate in the designated frequency band.  You may select E (East) or W (West).   

Antenna Elevation Angle Eastern Limit (B6E) 

Elevation angle in degrees of the antenna's main lobe of radiation associated with the eastern satellite orbital arc limit over which this earth station has been coordinated with the terrestrial facilities that share the same frequency band.  Enter numeric values only using the following format: nn.n For Fixed earth stations, this information is required in order to submit your application.  For Temporary fixed earth stations, this field is not needed and is grayed out The value entered must be between 5 degrees and 90 degrees.  If the value you entered is invalid, the following message displays, “The value entered for elevation angle is less than 5 degrees or greater than 90 degrees.  The value entered must be => 5 degrees and <= 90 degrees (pursuit to 25.205) and in nnn.n format.  You must provide a valid entry before this application can be processed further.”   

Antenna Elevation Angle Western Limit (B6F) 

Elevation angle in degrees of the antenna's main lobe of radiation associated with the western satellite orbital arc limit over which this earth station has been coordinated with the terrestrial facilities that share the same frequency band.  Enter numeric values only using the following format: nn.n.  For Fixed earth stations, this information is required in order to submit your application.  For Temporary fixed earth stations, this field is not needed and is grayed out  The value entered must be between 5 degrees and 90 degrees.  If the value you entered is invalid, the following message displays, “The value entered for elevation angle is less than 5 degrees or greater than 90 degrees.  The value entered must be => 5 degrees and <= 90 degrees (pursuit to 25.205) and in nnn.n format.  You must provide a valid entry before this application can be processed further.”

 Earth Station Azimuth Angle Eastern Limit (B6G) 

Azimuth angle in degrees relative to true north of the antenna's main lobe of radiation associated with the eastern satellite orbital arc limit over which this earth station has been coordinated with the terrestrial facilities that share the same frequency.  Enter numeric values only using the following format: nnn.n.  The value entered must be between 0 degrees and 360 degrees. 

Earth Station Azimuth Angle Western Limit (B6H) 

Azimuth angle in degrees relative to true north of the antenna's main lobe of radiation associated with the western satellite orbital arc limit over which this earth station has been coordinated with the terrestrial facilities that share the same frequency.  Enter numeric values only using the following format: nnn.n.  The value entered must be between 0 degrees and 360 degrees.   

Maximum EIRP Density toward the Horizon (dBW/4KHz) (B6I) 

Maximum transmitter power density transmitted toward the horizon expressed in dBW/4kHz for the band identified in the Lower Frequency Limit and (B6Bi) the Upper Frequency Limit (B6Bii) fields.  This value is relevant only for transmitting bands (i.e., 6 GHz or 14 GHz bands).  Enter numeric values only using the following format: nnn.n.  Negative values are allowed.   

Attachment Tab 

You have the option to either attach an Exhibit next to a qualification question requiring an exhibit or to attach an exhibit on the Attachment tab.  If an Exhibit is attached next to a qualification question, the exhibit type will be prefilled based on the question.

When an application is finalized, the system ensures that:

  • applications for  transmit/receive or transmit-only earth station license have a Radiation Hazard Study Exhibit

  • applications to operate in the C-band have a current (within six-months of this filing) Frequency Coordination Report Exhibit

The system will indicate any required Exhibits that are missing.  You will be prompted to attach all missing exhibits at the time that the application is finalized.  You may do this at the Attachment Tab.

To upload an attachment, perform the following steps:

  • Click the Replace/Attach icon

  • Enter file path or browse to locate and select file to be uploaded

Click the Upload button and the following attachment information displays:

  • Date Uploaded : Prefilled with System Date.

  • File Name

  • Attachment type: The exhibit type will be prefilled. 

    • Radiation Hazard Study

    • Frequency Coordination Report – This should be current (within six months of this filing)

The list will contain a hyperlink to each exhibit, as soon as the Exhibit has been converted to a .pdf file type by the system.  After conversion to a .pdf file type, you will be able to click on the hyperlink to view the exhibit.  You may also replace an Exhibit by clicking on the Replace/Attach box next to the exhibit.

Certification Tab

You are required to select one of the following items from the displayed list: Applicant is a (an):

  • Individual

  • Unincorporated Association

  • Partnership

  • Corporation

  • Governmental Entity

  • Other: If Other is selected, the user shall be required to provide an explanation (80 chars)

You are also required to enter all of the following information:

  • Typed Name of Person Signing

  • Title of Person Signing

  • Signature:  This field is grayed out.  The Applicant shall print out, sign in this field, and retain it as the official hard-copy for viewing by the Commission at a later date, if requested by the Commission.

  • Date Signed

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