Official Federal Forms > Federal Communications Commission (FCC)
CORES Registration 160 - Official Federal Forms
| CORES Registration Form. This is a national form and can be used in Federal Communications Commission (FCC) . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
READ INSTRUCTIONS CAREFULL Y Approved by OMB BEFORE PROCEEDING FEDERA L COMMUNICATIONS COMMISSION 3060-0917 Comm ission Re gistration System (CORES) September 2005 FORM 160 CORES Registration Form FCC USE ONLY # 1. Entity Type: ____ ____ Bu 2. siness Entity Type (if applicable): ____ ____ 3. Business Entity Name: ___________________________________________________________________________________ 3a. Salutation: ________ First Name: ______________________________________________________ Middle Initial: _____ Last Name: ___________________________________________________________________________ Suffix: ___________ 4. Doing Business or Trading As: ____________________________________________________________________________ 5. Taxpayer Identification Number / cial Security NumSo ber (9 digits): ______________________________________________ 6. Taxpayer Identification Numer Exceptib on Reason Code_: ___ ____ 7. Contact RepresentativeO rganization/Company _: ______________________________________________________________ 8. Contact Representative Position/Title: _______________________________________________________________________ 9. Contact Representative First Name: __________________________________________________ Middle Initial: _________ Contact Representative Last Name: ___________________________________________________________________________ 10. Address: _____________________________________________________________________________________________ 11. Address 2: ____________________________________________________________________________________________ 12. Address 3: ____________________________________________________________________________________________ 13. Address 4: ____________________________________________________________________________________________ 14. City: ________________________________________ 15. State: ___ ___ 16. Zip Code: ________________ - __________ 17. Country: _____________________________________________________________________________________________ 18. Contact Representative Phone Number: _____________________________19_ . FAX: ______________________________ 20. Contact Representative E-Mail: ___________________________________________________________________________ 21. Personal Security Question (select only one): 21 a . Custom Personal Security Question (if applicable): _______________ ___ Mothers Maiden Name ___ City of Birth ____________________________________________________ _____ ___ Favorite Pets Name ___ Corporate Internal Employee ID _________________________________________________________ ___ Custom Personal Security Question 22. Personal Security Question Answer: _______________________________________________________________________ 23. Certification Statement: I, ___________________________, certify under penalty of perjury that the foregoing and supporting information is true and correct to the best of my knowledge, information, and belief. Signature: _________________________________________________________ Date: _______________________________ 1 American LegalNet, Inc. www.USCourtForms.com <<<<<<<<<********>>>>>>>>>>>>> 2 ADVICE REFERENCE GUIDE HOW TO USE FCC FORM 160-(CORES) REGISTRATION FORM The FCC Form 160, CORES Registration Form, is a form that must be completed to obtain a FCC Registration Number (FRN). The FCC Registration Number will be assigned by the Commission Registration System (CORES) and is required for anyone doing business with the Commission (feeable and non-feeable T).he information on this form is collected to ensure you receive any refunds due, to service public iniries, and tquo comply with the Debt Collection Improvement Act of 1996. The FRN can be obtained electronically through the FCC webpagwww.fcc.ge: ov/frnreg. Instructions for Completing FCC Form 160 NOTE: All required blocks must be completed or it may result in a delay in processing or the return of your application. All blocks are required unless otherwise stated. (1) Enter the Entity Type from the codes below: 01 - Individual 02 - Private Sector 03 - Federal 04 - State 05 - Local 06 Foreign (2) Enter Business Entity Type (only respond if you selected 02 - Private Sector in Number (1) above): 01 - Corporation 02 - University 03 - Partnership 04 - LLC 05 - Attorney 06 - Joint Venture 07 - Trust 08 - Association 09 - Consortium 10 - Amateur Club 11 - Non-Profit/Exempt Organization (3) Business Entity Name (only applicable to businesses) En: ter the entity name or company used commercially. (3)(a) Entity Name (only applicable to individuals): Enter the name of the individual registrant. Enter the first name and last name, as well as the salutation, middle initial, and suffix if necessary. (4) Doing Business As/Trading As (optional): Enter Doing Business As or Trading As name. (Only if individual entity) (5) Taxpayer Identification Number / Social Security Number: Enter the entitys nine-digit Taxpayer Identification Number (TIN). The Taxpayer Identification Number will either be an Employer Identification Number (EIN) or Social Security Number (SSN) of the payer as reported to the Internal Revenue Service. If yodou not have a (TIN), complete Block 6. (6) Enter Taxpayer Identification Number exception reason code (if applicable; see (5) above): Code Reason Type Ex planation 01 -TIN Applied Fo: r Entity is currently applying for a TIN, but has not yet received one. 02 -En tity is Foreign: Entity is not required to have a TIN due to a foreign status under IRS rules. 03 -En tity is Petitioner: Entity has contact with the FCC only as a petitioner. 04 -Exemp t Activities: Entity is exempt under Internal Revenue Service (IRS) rules from obtaining a TIN. 05 -Am ateur Club: Entity is a non-profit amateur radio club. (only applicable to businesses) 06 -Triba l government or entity: Entity is a tribal government or similar organization within the U.S. (only applicable to businesses) (7) Contact Representative Organization/Company (optional): Enter the name of the contact representative organization or company. A contact representative is the individual who will be contacted with any business concerning this FRN. (8) Contact Representative Position/Title (only applicable to businesses): Enter the contact representative title. (9) Contact Representative Name: Enter the name of the contact representative. Enter the first name, middle initial and last name. 2 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3 (10) Address: T
|
|||||||
