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 | FORMAN, GLENN W |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | GLENN W FORMAN |
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| Street Address | 748 GOOSE NECK DRIVE |
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| Po Box | |
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| Locality | LITITZ |
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| County | Lancaster County |
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| State | PA - Pennsylvania |
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| Postal Code | 17543 |
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| Zip Location | 40°10'51.7"N 76°17'43.4"W |
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| Maidenhead | FN10ue |
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| FRN | 0003363488 |
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| Geo Region | 3 / PA |
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| Licensee ID/SGIN | L00172343 / 000 |
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| Callsign | W3QQQ |
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| Last Action Date | 2004-04-23 |
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| Radio Service | HV - Vanity |
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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 | 2004-04-05 |
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| Fee Control Num | 0404058994883684 |
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| Orig Purpose | MD - Modification |
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| Receipt Date | Mon 2004-04-05 |
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| Payment Date | 2004-04-06 |
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| Is From Vec | |
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| Is Trustee | |
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| Operator Group | B - 2x2 |
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| Licensee Class | A - Advanced |
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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 | B / 3 |
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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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