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 | BLOM, JEFFREY R |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | JEFFREY R BLOM |
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| Street Address | 12545 SE 92nd Terrace |
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| Po Box | |
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| Locality | Summerfield |
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| County | Marion County |
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| State | FL - Florida |
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| Postal Code | 34491 |
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| Zip Location | 28°59'44.3"N 82°03'18.5"W |
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| Maidenhead | EL88xx |
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| FRN | 0006252068 |
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| Geo Region | 4 / FL |
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| Licensee ID/SGIN | L00457039 / 000 |
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| Callsign | WB2GSM |
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| Last Action Date | 2005-04-12 |
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| Radio Service | HA - Amateur |
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| App Purpose | AU - Administrative Update |
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| App Source | I - Online |
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| App Status | G - Granted |
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| Entered Timestamp | 2005-04-09 |
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| Fee Control Num | |
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| Orig Purpose | |
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| Receipt Date | Mon 2005-04-11 |
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| Payment Date | |
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| Is From Vec | |
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| Is Trustee | |
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| Operator Group | D - 2x3 |
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| Licensee Class | E - Amateur Extra |
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| New Seq Callsign | |
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| Trustee Callsign | |
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| Trustee Name | |
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| ULS Group / ULS Region | D / 4 |
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| Prev Callsign / Prev Class | |
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| Vanity Relationship | |
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| Vanity Type | |
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| Fee Exempt / Waiver | N / N |
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