Contact Information *=required
Name *
Call (if any)
Email address *
Phone (indicate best time(s) to call: *
What is the best way to contact you? (phone, email text) *
Interference Information
Fill in any answers for questions that are not applicable with ‘NA’
Frequencies and/or bands of interference (list lowest frequency, first):
Any particular time of day or recognizable pattern (all the time, only during the day, certain days of the week, any regular interval):
Any relationship to heavy rains? Or worse in the winter than summer?
Approximate strength (in S-units at your location) and, if you have a directional antenna, direction where the noise is strongest; if possible have another ham in your vicinity with a directional antenna do the same and indicate both headings and both locations:
Is your Over The Air (OTA) TV or satellite affected (circle answer)?
Yes
No
Maybe
Other:
AM/FM reception affected (Circle answer)?
Yes
No
Maybe
Other:
Troubleshooting Steps
Fill in any answers for questions that are not applicable with ‘NA’
Have you performed all the checks in your own home to try and isolate the noise source? Have you completed the decision tree and been instructed to contact the RFI Team for your section? What have you already tried to help isolate the problem?
If you found the source of noise, describe it by type of equipment, make, model #
Have you tried to walk outdoors with an HT? Used a portable AM/FM radio to gauge proximity? Driven around with a car radio on AM and seeing if there is a direction or location that is worse than others?
Does this appear to be jamming or intentional interference (circle answer)?
Yes
No
Maybe
If you believe the noise is coming from a neighbor, have you tried to get his/her cooperation to locate it inside their home? Is the neighbor friendly?
Please include any screen shots or pictures of radio screens.