Field Name · Applicant
Italic names are derived; accent values differ from the applicant’s prior license.
| Applicant Type | B - Amateur Club |
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| Entity Type | L - Licensee or Assignee |
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| Entity Name | QCWA PALM BEACH CHAPTER #111 |
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| Attention | JEFFREY J BEALS |
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| First Name / Middle Init / Last Name / Name Suffix | |
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| Street Address | |
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| Po Box | 1584 |
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| Locality | LOXAHATCHEE |
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| County | Palm Beach County |
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| State | FL - Florida |
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| Postal Code | 33470 |
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| Zip Location | 26°43'46.0"N 80°19'11.5"W |
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| Maidenhead | EL96ur |
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| FRN | 0005103262 |
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| Geo Region | 4 / FL |
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| Licensee ID/SGIN | L00365638 / 000 |
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| Callsign | KG4NWH |
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| Last Action Date | 2003-06-06 |
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| Radio Service | HA - Amateur |
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| App Purpose | MD - Modification |
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| App Source | I - Online |
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| App Status | G - Granted |
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| Entered Timestamp | 2003-05-17 |
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| Fee Control Num | 0305178994896789 |
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| Orig Purpose | MD - Modification |
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| Receipt Date | Mon 2003-05-19 |
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| Payment Date | 2003-05-20 |
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| Is From Vec | |
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| Is Trustee | |
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| Operator Group | C - 1x3 |
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| Licensee Class | trustee: E - Amateur Extra |
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| New Seq Callsign | N |
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| Trustee Callsign | WA4AW |
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| Trustee Name | BEALS, JEFFREY J |
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| ULS Group / ULS Region | C / 4 |
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| Prev Callsign / Prev Class | |
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| Vanity Relationship | Spouse |
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| Vanity Type | D - In Memoriam (Club) |
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| Fee Exempt / Waiver | N / N |
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