Gov't Print/35/77/TELE

Form Lic. 2. License No.....................

STATE OF BRUNEI

AMATEUR STATION LICENSE

In pursuance and exercise of the powers and authority conferred upon the Director of Telecommunicatons under section 3 (a) of the Emergency (Control of Radiocommunication) Orders 1967 and subject to Regulations of the International Telecommunication Convention, a license is granted to:

to establish and work.................................................................................................................station

specified below in the..........................................................................................................................

for a period ending.......................................19..........

The station shall be subject to inspection. ... etc. ...

PARTICULAR OF STATION

Name of owner...................................................................................................................................

Call sign..............................................................................................................................................

Class of Station under
International Telecom-.........................................................................................................................
munications Convention

Frequencies (Waves)...........................................................................................................................

Types of transmission...........................................................................................................................

Fee Paid $....................................................... Receipt

No...........................................dated.......................................

Signature of licensee

....................................................................... (please sign here)

Date................................................................

Director of Telecommunication,
Brunei.
(Licensing Authority)

Director of Telecommunications
Telecommunications Department
BANDAR SERI BEGAWAN
Brunei Darussalam


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