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 | CLARK, JEROLD W |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | JEROLD W CLARK |
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| Street Address | 426 S LEE |
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| Po Box | 1524 |
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| Locality | FORT GIBSON |
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| County | Muskogee County |
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| State | OK - Oklahoma |
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| Postal Code | 74434 |
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| Zip Location | 35°48'34.4"N 95°12'39.1"W |
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| Maidenhead | EM25jt |
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| FRN | 0002210128 |
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| Geo Region | 5 / OK |
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| Licensee ID/SGIN | L00227849 / 000 |
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| Callsign | KC5QJX |
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| Last Action Date | 2005-05-14 |
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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 | 2005-04-26 |
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| Fee Control Num | 0504268994888574 |
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| Orig Purpose | MD - Modification |
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| Receipt Date | Tue 2005-04-26 |
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| Payment Date | 2005-04-27 |
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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 | G - General |
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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 / 5 |
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| Prev Callsign / Prev Class | |
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| Vanity Relationship | |
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| Vanity Type | A - Former Holder |
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| Fee Exempt / Waiver | N / N |
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