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 | BERGERON, CARLOS A |
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| Attention | Good Samaritan Society St. Croix |
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| First Name / Middle Init / Last Name / Name Suffix | CARLOS A BERGERON |
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| Street Address | 750 E Louisiana St |
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| Po Box | |
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| Locality | St. Croix Falls |
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| County | Polk County |
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| State | WI - Wisconsin |
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| Postal Code | 54024 |
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| Zip Location | 45°30'06.1"N 92°38'26.6"W |
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| Maidenhead | EN35qm |
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| FRN | 0004800108 |
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| Geo Region | 9 / WI |
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| Licensee ID/SGIN | L00328704 / 000 |
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| Callsign | N9GIM |
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| Last Action Date | 2015-12-15 |
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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 | 2015-12-12 |
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| Fee Control Num | |
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| Orig Purpose | |
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| Receipt Date | Mon 2015-12-14 |
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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 | C - 1x3 |
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| Licensee Class | G - General |
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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 | C / 9 |
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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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