e4 CHANGE OF KEEPER NOTIFICATION FORM

This form should be used to apply for a CHANGE OF KEEPER for a Repeater or Digital Node.
The information required comprises details of yourself, the outgoing Keeper, the incoming Keeper, and reason for the change.
ALL questions should be completed, but the form will not send unless fields denoted* are completed plus the image verification (spam-resistant measure)

Section 1 - The person completing this form

You may be the retiring Keeper, the replacement Keeper, or a third party.
Don't worry about repeating details on this form.

Your Name: (required)
Your Callsign:  

Section 2 - The Retiring Keeper

In the case of a deceased Keeper this should be stated in Section 2 below in which case the incoming Keeper will complete the details here.

Keeper First Name:    *   Surname:   *  Callsign:  *
Address: 
Town/County: 
Postcode    Phone Code:  Phone Number: 
E-mail address: 

Section 3 - Service Affected/Reason

Repeater Callsign:    Type:   *
Reason for change:     *

Section 4 - Incoming Keeper

New Keeper First Name:    *   Surname:   *  Callsign:  *
New Keeper Address: 
Town/County: 
Postcode    Phone Code:  Phone Number: 
E-mail address:  *

Section 5 - New Keeper Amateur Licence

File to upload: 

FOOTNOTE

This form should only be used to change the NoV holder for an established repeater or digital node.
Any change of site, or other changed technical parameters will require the submission of a new e1 application form.
 
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