0003-EX-MN-2017

Filing overview

442 application form

Is applicant a foreign government or a representative of a foreign government?

NO

442 application form - Application for Medical Testing License

Applicant (Company) Name:

MTest

Applicant's FCC Registration Number (FRN):

0005072848

Attention To:

Ben Ghaffari

City:

herndon

Country (If not the United States):

US

E-mail Address:

benny_g4@hotmail.com

P.O. Box:

PO 123

State:

American Samoa

Street Address:

445 12th Street SW,

Zip Code:

20554

442 application form - Authorized Party to Sign

Signature Date:

2017-03-15 10:59:15.32

Signature of Applicant (Authorized person filing application):

B.ghaffari

Title of Person Signing Application:

Engineer

442 application form - Eligibility Questions

Applicant affirms that they are a health care facility as defined in section 95.1103(b) of the Commission ’s rules

YES

Will this license involve clinical testing trials

YES

442 application form - Give the following information of person who can best handle inquiries pertaining to this application:

First Name:

Ben

Last Name:

Ghaffari

Phone Number:

202-418-7928

Title:

Engineer

442 application form - Initial values - Authorized Party to Sign

Signature Date:

2017-03-15 11:03:26.79

442 application form - Insert a short description of the purpose of this application, or for modifications describe what is being modified.

Narrative Comment:

* Insert a short description of the purpose of this application, or for modifications describe what is being modified:

442 application form - Location Information

North Latitude:

38 ° 59 ' 24 "

State:

Virginia

Street Address:

12536 ridgegate dr

West Longitude:

77 ° 22 ' 35 "

442 application form - Medical Testing License Questions

Do you intend to operate on commercial mobile radio service (CMRS)?

NO

Do you intend to operate on public safety frequencies?

NO

Do you intend to use any of the federal exclusive and shared frequencies?

YES

Grant actions

Notes

Documents