148
CAP. 411A
Kenya Information and Communications
[Subsidiary]
[Rev. 2011
First Schedule—(Contd)
FORM NO. 2
Regulations 52 and 57
COMMUNICATIONS COMMISSION OF KENYA
APPLICATION FOR TYPE APPROVAL/ACCEPTANCE
1.
PARTICULARS OF VENDOR
(i) Full names of Company/Business
………………………………………………………………………………
P.O. Box ………………………………… Tel No.: …………………………
Fax No…………………………………. E-mail …………………………….
(ii) Physical Address:
Town …………………….. Estate …………………. Street/Road …………
Name of building …………………. Floor ………………… Room ……….
2.
DESCRIPTION OF EQUIPMENT
ITEM
NO
TYPE
MANUFACTURER
7 M A K E A N D SERIAL
C O U N RT Y
MODEL
N U M B E R / OF
IMEI
ORIGIN
3.
REQUIRED ITEMS
(i) Letter of Agency from manufacturer or principal distributor.
(ii) Non-refundable approval/acceptable fee of Ksh ……… vide Receipt
No ………… of …………………
(iii) Sample of equipment/instrument model complete with associated accessories
and attachments.
(iv) Detailed technical documentation (operation, programming, service,
technical, circuitry) in English language.
(v) Test report (Results) from manufacturer or accredited laboratories and test schedules.
(vi) List from manufacturer stating other countries where the equipment is type
approved and in service.
4.
DECLARATION
I hereby apply for provisional Type Approval/Acceptance/authority to market the equipment(s)
specified above in Kenya on behalf of my company. I certify that all the information I have given in
this form is correct to the best of my knowledge.