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 | WILLIS, DEREK E |
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| Attention | |
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| First Name / Middle Init / Last Name / Name Suffix | DEREK E WILLIS |
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| Street Address | 136 Old Mill Creek Rd |
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| Po Box | |
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| Locality | DAWSONVILLE |
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| County | Dawson County |
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| State | GA - Georgia |
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| Postal Code | 30534 |
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| Zip Location | 34°25'52.0"N 84°08'39.6"W |
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| Maidenhead | EM74wk |
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| FRN | 0007400245 |
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| Geo Region | 4 / GA |
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| Licensee ID/SGIN | L00545614 / 000 |
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| Callsign | KG4UGU |
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| Last Action Date | 2022-08-09 |
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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 | 2022-08-08 |
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| Fee Control Num | PGC3885751 |
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| Orig Purpose | |
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| Receipt Date | Mon 2022-08-08 |
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| Payment Date | 2022-08-08 |
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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 | T - Technician |
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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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