Field Name · Applicant
Italic names are derived; accent values differ from the applicant’s prior license.
| Applicant Type | I - Individual |
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| Entity Type | L - Licensee or Assignee |
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| Entity Name | BURGESS, Jack |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | Jack BURGESS |
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| Street Address | 728 21st Street |
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| Po Box | |
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| Locality | Springfield |
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| County | Lane County |
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| State | OR - Oregon |
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| Postal Code | 97477 |
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| Zip Location | 44°03'30.5"N 123°00'41.7"W |
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| Maidenhead | CN84lb |
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| FRN | 0007473325 |
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| Geo Region | 7 / OR |
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| Licensee ID/SGIN | L00552255 / 000 |
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| Callsign | KE6FXZ |
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| Last Action Date | 2004-01-27 |
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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 | 2004-01-09 |
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| Fee Control Num | 0401098994881042 |
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| Orig Purpose | MD - Modification |
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| Receipt Date | Fri 2004-01-09 |
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| Payment Date | 2004-01-10 |
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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 | T - Technician |
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| New Seq Callsign | N |
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| Trustee Callsign | |
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| Trustee Name | |
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| ULS Group / ULS Region | C / 7 |
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| Prev Callsign / Prev Class | |
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| Vanity Relationship | |
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| Vanity Type | E - By List |
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| Fee Exempt / Waiver | N / N |
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