1.

Administrative details:
a)

b)
c)

d)
e)
2.

Name of the organisation(or
individual)………..........................................................................
Nationality………………….ID/PP No………………………..…………….
Postal address..............................................…….................……....................
Business Telephone............................. Fax..…..………...................…...........
Physical Location: Road/Street………....Building…………LR No…..…….
Name and postal address of the local supplier (if any)........................….......
Postal address...........................………...........................................................
Business Telephone.................................... Fax...........................................
Type of radio communication service
service:……………………………………………….
• HF
• MF
• FM
(delete as appropriate)
Authorised broadcast area(s)…………………………………………………
(attach certified copy of broadcasting permit)
Name of person / organisation responsible for payment of
bills....................................... ............................................…….......................

Transmit Site Details:
i)
ii)
iii)
iv)
v)
vi)

3.

Name...........................................................................
Land registration number. .....................................................
Road/Area .........................................................................…...
Geographical co-ordinates:
Latitude :
Degrees..........Minutes ..….......Seconds ............ (N/S)
Longitude : Degrees....…..Minutes .….........Seconds .....…….(E)
Altitude above sea level (in metres).....……….......................……..
Relative height around 15 kilometre radius
....…...............................

Transmitter Equipment Details:
a)

Equipment and performance characteristics.
i)
Name ......................................................................................
Model .............……….......…..................................................
Serial number ........……….....................................................
ii)
Carrier output power............……….......................................
iii)
Effective Radiated Power (dBW) ..……….............................
iv)
Transmission system (applicable to FM systems only) :
……………………..
• System 1:
Monophonic, max deviation +/−75 kHz
• System 2:
Monophonic, max deviation +/−50 kHz
• System 3:
Stereophonic ,polar modulation, max deviation
+/−50 kHz
• System 4:
Stereophonic, pilot tone system , max deviation
+/−75 kHz

83

Select target paragraph3