SEYCHELLES LICENSING AUTHORITY
P.O. BOX 3
VICTORIA, MAHE
REPUBLIC OF SEYCHELLES
TEL: +248-224 314, fax. +248-224 256
APPLICATION FOR A LICENCE
APPLICATION FOR A LICENCE IN BROADCASTING
OR TO INSTALL/ESTABLISH ANY BROADCASTING SERVICES IN ACCORDANCE
WITH
THE LICENCE (BROADCASTING AND TELECOMMUNICATION) REGULATIONS 1988
Application to be completed in Triplicate.
A. DETAILS OF APPLICANT
1. Name:....................................................................... 2. Style: (Dr./Mr./Mrs./Miss):.........................
3. Address:.................................................................... ....................................................................
5. Organisations Names:................................................ 4. Nationality:.................................................
7. Registered Address:..............................:.................... 6. Telephone Number:....................................
9. Relevant Experience (See Note 5):............................. 8. Certificate of Registration No. ...................
.................................................................................. 10. Age:..........................................................
B. DETAILS OF EXISTING OR LAST HELD LICENCE/APPLICATION
1. Date of Expirity Licence:...................................................................................................................
2. Number of licence:............................................................................................................................
3. If this application is to amend an existing licence ...... Tick this box (See Note 6) |__|
4. If no previous licence is held state have applied for a licence before: YES |___| NO |___|
a) If YES, when (state date):.................................................................................................................
b) If NO, Reason given for refusal:........................................................................................................
5. State if this application is for a NEW |___| RENEWAL |___| AMENDMENT |___|
C. DETAILS OF LICENCE/SERVICE REQUIREMENT D. DETAILS OF EQUIPMENT AND TRANSMISSION
(a) TYPE (Please tick the boxes) ..............................a) Transmitter(s) . |___| b) Receive..........|___|
1. Establish Broadcasting Service .................................c) Radar(s) ..........|___| d) Transceiver(s) |___|
2. Engage in Broadcasting ............................................e) Cordless Tel(s) |___| f) .....................
3. Install a Broadcasting Apparatus....................................Others ........... |___|
4. Establish or install Telecommunications .........................Model(s) ..................................................
5. Other (Specify) ...........................................................Serial No(s) .............................................
RESTRICTED OPERATOR'S CERTIFICATE OF PROFICIENCY (ROCP) No.......................
E. CATEGORY
3401 Cordless Telephone ....................................................
2. Frequency Bands: MF HF VHF UHF
3402 Paging System
3403 Navigational Aids .......................................................
3. Maximum Power Output of Apparatus:
3404 Broadcasting ..............................................................
(Please attach a copy of specifications)
3405 Amateur Radio
3406 Private Craft ...............................................................4.
Operational Frequencies/Channel No(s):
3407 Walkie Talkie
3408 Hire Craft ...................................................................5.
Bandwidth: (kHz/MHz)
3409 Land Fixed
3410 Mixed .........................................................................6.
Types of Emission VOICE TELEGRAPHIC DATA
3411 Aeronautical
3412 Land Mobile ................................................................7.
Type of Modulation (If known):
3413 Earth Station
3414 Maritime Service .........................................................
8. Purpose of Emission:
3415 Miscellaneous
9. Will Maintenance be by Licensee or other? .......................
10. Location of Apparatus: ...........................................................................................Please specify)
11. Location of Receiving Points: ..........................................
12. Location, Type and Nature of Antennae:
13. Do you have a copy of the Broadcasting & Telecommunications Licensing Regulations?
DECLARATION:
I hereby declare that the foregoing is true and correct and nothing is false therein and nothing material has been concealed therefrom. I also agree that in case any information given by me herein before is found false at a later date, the licence, if granted, will be cancelled. I have carefully read and understood the rules/regulations contained in the Seychelles Telecommunications (Licensing) Regulations and undertake to abide by them and observe the conditions of the licence.
Name in Block Capitals:...................................................................
Signature of the Applicant:...............................................................
Date:..............................................................................................
A surcharge of 10 % of the licence fee will be added for each month or part thereof which has elapsed from the date of the expiration of the licence of an application.
FOR OFFICIAL USE
Licence fee R. ..................................... Processing fee R. ......................................
Surcharge fee R. .................................. Cash/Cheque No. ......................................
Paid on ................................................ Receipt No. ..............................................
Comments of consulting departments.
........................................................................................................................................
........................................................................................................................................
Approved/Not Approved
DATE .................................................