ICT Policy Africa

Rev. 2011]

Kenya Information and Communications

CAP. 411A

149

[Subsidiary]

First Schedule—(Contd)
Applicant’s
Name ……………………………………… Sign ……………. Date………
Contact Tel No …………………………….

	
	

5. 		

FOR OFFICIAL USE ONLY

	
(i)	
	
(ii) 	
	
(iii)	
		
	
(iv) 	

Case No. ………………………………………………..
Evaluating officers name ………………… Sign ………
Approval Recommended/Not Recommended (Delete
where not applicable).
TAC No……….. Approved/Not Approved/Deferred (Delete where applicable)

FORM NO. 3

Regulation 57
COMMUNICATIONS COMMISSION OF KENYA

APPLICATION FOR FINAL TYPE APPROVAL/ACCEPTANCE
1. 	

PARTICULARS OF VENDOR

	
i)	
Full names of Company/Business
		………………………………………………………….............................
		
P.O. Box………...............……......... Tel No.: ………… Fax No ……….
		Email …………………………
	
ii) 	
		
		

2. 	
ITEM
NO

3. 	

Physical Address:
Town ………......…… Estate ………….. Street/Road …………………
Name of Building ……………… Floor……………….. Room……….

DESCRIPTION OF EQUIPMENT
TYPE

MANUFACTURER

DETAILS OF INSTALLATIONS

MAKE AND
MODEL

SERIAL
C O U N RT Y
NUMBER/IMEI OF
ORIGIN