159-B_final version with OMB approval 2023

Approved by OMB

FEDERAL COMMUNICATIONS COMMISSION

3060- 0589

REMITTANCE ADVICE
BILL FOR COLLECTION

Estimate time per
response-10minutes-4hours
Page __
1 of __
1

Bill Number

Applicant FRN

FOR INQUIRIES CALL

Current Bill Date

1-202-418-1995
(Revenue and Receivable Operations Group)

Debtor Information:

Due Date

Total Amount Due

TOTAL AMOUNT DUE MUST BE RECEIVED BY
Payer FRN No.

Please Complete The Payer Information, FCC Registration Number (FRN) is required

Payer Name (if paying by credit card enter name as it appears on the card)
Address Line No. 1
Address Line No. 2
City

State

Zip Code

Daytime Phone Number (include area code)
Reason For Bill:

Call Sign/Other FCC
ID

Payment Type Code

Quantity

Fee Due For (PTC)

TOTAL DUE

Total Fee

FCC Code 1

FCC Code 2

0

AUTHORIZED SIGNATURE_________________________________________________________

DATE_____________________________________

FCC FORM 159B JULY 2023

FEDERAL COMMUNICATIONS COMMISSION

REMITTANCE ADVICE
BILL FOR COLLECTION

Approved by OMB
3060 -0589

(Continuation Sheet)
Bill Number

Applicant FRN

Current Bill Date

Call Sign/Other FCC
ID

Payment Type Code

Quantity

1 of __
1
Page __

Estimate time per
response-10 minutes-4
hours

Fee Due For (PTC)

BALANCE FORWARD

Total Fee

FCC Code 1

FCC Code 2

0
FCC FORM 159 B