Fillable 630b0de4-9a55-4978-a349-5dc74644eedb P25 ID Request Form

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630b0de4-9a55-4978-a349-5dc74644eedb P25 ID Request Form

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File type: PDF

U.S.A. forms for City of Fortworth

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CFW Use Only
Request Sponsor Assigned
Request Complete
Request Approved
Agency IDs Approved
Lowest ID in Range
Highest ID inRange
Name of Agency Entity:
Functional Subdivision:
Agency Main Number:
Contact Name:
Title:
Desk Phone:
24 Hour Contact:
Cell Phone:
Email:
Street Address:
City:
State:
Zip:
Contact Name:
Agency or Company:
Title:
Desk Phone:
24 Hour Contact:
Cell Phone:
Email:
Street Address:
City:
State:
Zip:
CFW P25 Radio Network - (P&P 1 Forms)
Agency Radio ID and Access Request Form (v8)
Please select one from drop down menu:
Will any radios require an Advanced System Key (ASK) to program? (yes/no)
Radio Technician/Programmer Information
Do you have an experienced radio programmer available? (yes, no) If yes, please complete information at right.
Select from drop down menu
Radio Technician/Programmer Address:
Agency Address:
Authorizing Point of Contact for Agency:
This form is for the purposes of requesting public safety agency access to the P25 Overlay
interoperability system. All information needs to be accurately completed in order to process
your request. This document contains sensitive information, so please distribute
discriminately.
Type of Request
AGENCY INFORMATION
Same as above (yes/no)
This Form Functions Best When Using Internet Explorer.
Enter quantities for each
Total
Quantity
select from pull down
Count
*Desired Radio
User Aliases
(Max 7
characters)
Subdivision for
RADIO
Serial Number
1
2
3
4
5
6
7
8
9
10
11
12
Type of Radio
Comments/Notes :
Other Mfg. Name:
(A) Aircraft device:
(C) Dispatch Console:
(M) Mobiles for vehicles or control stations:
(P) Portable hand-helds:
Estimated number of additional radio units which may require access in next 24 months
Number of radio units available for immediate programming
GENERAL RADIO INFORMATION
RADIO INFORMATION
Motorola :
Harris :
Other:
Radio Manufacturer
**Series Name
13
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18
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25
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33
Submit Form
List any additional Radio information on
the next page before submitting the Form
INDIVIDUAL RADIO INFORMATION
You may submit the Form at this point and attach a file to the submission Email listing the " Individual Radio Information" .
If attaching a file it should contain the information as listed below.
0
Submit Form & Attach Radio Info File
Count
Type
(P/M/A)
*Desired Radio
User Aliases
(Max 7
characters)
Radio Manufacturer
Subdivision for
RADIO
Serial Number
**Series Name
34
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45
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Submit Form
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630b0de4-9a55-4978-a349-5dc74644eedb P25 ID Request Form

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Completed 12 July 2020

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