Attachment FCC

This document pretains to ROA-NEW-20170215-00001 for New Application on a Recognized Operating Authority filing.

IBFS_ROANEW2017021500001_1187158

FCC Form 602 FCC Ownership Disclosure Information for the Approved by OMB Main Form Wireless Telecommunications Services 3060 – 0799 See instructions for Public burden estimate Re Submitted 02/15/2017 at 5:59 AM File Number: 0007661910 Filing Type 1) □ X Current Filing □ Proposed Filing fer Filer Information 2) First Name (if individual): MI: Last Name: Suffix: 3) Filer Name (if entity): DRAKE 4) FCC Registration Number (FRN): 0025700022 5) Contact Information Name and Address: Telephone Number: 646-820-0651 Aubrey Graham en Fax Number: 916-664-4970 2220 Colorado ave Santa monica, CA 90404 E-mail Address: Itsms546@gmail.com Attn: Drake Related FCC Regulated Businesses of Filer 6a) 6b) 6c) 6d) Percent of Interest Held: Name of all FCC-Regulated Businesses owned by Principal Business: FCC Registration Number c Filer (use additional sheets, if necessary): (FRN): Signature eC 7) Typed or Printed Name of Party Authorized to Sign First Name: Marie MI: Last Name: Davis Suffix: Title: Licensee Signature: Marie Davis Date: 02/15/2017 WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Title 18, Section 1001) AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Title 47, Section 312(a)(1) AND/ OR FORFEITURE (U.S. Code, Title 47, Section 503). op y FCC 602 Main Form May 2014


Document Created: 2019-04-10 13:46:16
Document Modified: 2019-04-10 13:46:16
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