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

