If you need assistance with this form, please call +1-410-266-6030. Ground Station Interference Form Submitter's Information Name * Name First First Last Last Phone * Email * Administrative Information Licensee Name * Contact Name Contact Name First First Last Last Address Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Phone * Email * Description & Location of System Affected FCC Call Sign * Frequency * Transmitter Address * Transmitter Address Transmitter Address Transmitter Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Coordinates Physical location of radio * (Bldg #, Room #, etc) Physical Location of Antenna * (e.g., On roof above gate C10) Interference Description Approximate Description of Interference * (Constant, Intermittent, Sporadic, etc) Type of Interference Being Received * (Voice, Data Bursts, Squeals, etc) How long has the interference been going on? * Remarks If you are human, leave this field blank. Submit
