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, WORTH |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | WORTH CLARK |
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| Street Address | 5088 DOVER BLUFF RD |
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| Po Box | |
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| Locality | WAVERLY |
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| County | Camden County |
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| State | GA - Georgia |
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| Postal Code | 31565 |
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| Zip Location | 31°04'01.6"N 81°37'56.1"W |
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| Maidenhead | EM91eb |
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| FRN | 0005346614 |
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| Geo Region | 4 / GA |
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| Licensee ID/SGIN | L00416192 / 000 |
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| Callsign | KG4PXG |
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| Last Action Date | 2011-09-27 |
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| Radio Service | HA - Amateur |
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| App Purpose | RO - Renewal Only |
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| App Source | I - Online |
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| App Status | G - Granted |
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| Entered Timestamp | 2011-09-26 |
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| Fee Control Num | |
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| Orig Purpose | |
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| Receipt Date | Mon 2011-09-26 |
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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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