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 | Sample, Jeffery |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | Jeffery Sample |
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| Street Address | 496 MAZE RD |
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| Po Box | |
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| Locality | RIDGELY |
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| County | Lake County |
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| State | TN - Tennessee |
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| Postal Code | 38080 |
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| Zip Location | 36°12'25.5"N 89°31'09.1"W |
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| Maidenhead | EM56fe |
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| FRN | 0012760484 |
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| Geo Region | 4 / TN |
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| Licensee ID/SGIN | L00976692 / 000 |
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| Callsign | KI4IRS |
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| Last Action Date | 2015-02-10 |
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| Radio Service | HA - Amateur |
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| App Purpose | RM - Renewal/Modification |
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| App Source | B - Batch |
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| App Status | G - Granted |
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| Entered Timestamp | 2015-02-10 |
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| Fee Control Num | |
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| Orig Purpose | RM - Renewal/Modification |
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| Receipt Date | Tue 2015-02-10 |
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| Payment Date | |
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| Is From Vec | N · Y |
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| Is Trustee | |
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| Operator Group | D - 2x3 |
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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 | 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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