| Lighthouse name as shown in gov. documents *: | |
| WGS84 Latitude in decimal format +/- DD.DDDDDD *: | |
| WGS84 Longitude in decimal format +/- DDD.DDDDDD *: | |
| Other names this light is known by: | |
| Current or prior government identification numbers *: | |
| Description of light and its structure (iron, wood, brick, color, etc.) *: | |
| Adjacent buildings that may help folks find this light: | |
| URLs of web sites showing this light (one URL per line): | |
| State or Province if applicable: | |
| ARLHS Prefix (USA, DEN, ARG, etc.) or name of country *: | |
| Your name and, if you are a ham, your callsign *: | |
| Email or other way to contact you *: | |
| Do you have any additional comments for the WLOL committee?: | |
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