152
CAP. 411A
Kenya Information and Communications
First Schedule—(Contd)
[Subsidiary]
4.
[Rev. 2011
DECLARATION
I hereby apply for authority to use the equipment specified above in Kenya. I certify that
all information I have given in the form is correct to the best of my knowledge.
Applicant’s
Name …………………………………… Sign …………. Date …………
Contact Tel No ……………………………………
5.
FOR OFFICIAL USE ONLY
(i)
Case No ………………………………
(ii)
Evaluating officers name ……………………. Sign ……………
(iii)
Approval Recommend/Not Recommended (Delete where not applicable).
(i) TAC
No…………………….. Approved/Not
Approved/Deferred (Delete where applicable).
FORM NO. 5
Regulation 18
COMMUNICATIONS COMMISSION OF KENYA
APPLICATION FOR FREQUENCY ASSIGNMENT AND LICENCE IN RADIO
COMMUNICATION SERVICE
1.
Administrative details:
a)
Name of the organization (or individual) ………………………
Nationality ……………… ID/PP
No …………………
Postal address ……………………………
Business Telephone ………………………… Fax …………………
Physical Location: Road/Street ………… Building ……… LR No…………
b)
Name and postal address of the local supplier (if any) ……………
Postal address …………………
Business Telephone ………………….. Fax ………………
c)
Type of radio communication service
service: ………………
• HF
• MF
• FM
(delete as appropriate)
d)
Authorised broadcast
area(s) ……………………………………