Application for license of radio equipment apparatus - BTRC

Bangladesh Telecommunication Regulatory Commission (BTRC)Application Form for License of Radio Communication Apparatus1. Name of Applicant: ................................................................................................................................2. Present Postal Address: ..........................................................................................................................3. Name of Contact Person: ..................................................................................Designation .................Mobile: ……………………… Telephone: ………… Fax: ………… E-mail: …………………….4. Nationality: .............................................................................................................................................5. Name and Address of Local Agent:........................................................................................................6. Purpose of License:.................................................................................................................................7. If Frequency Allocated Please Mentioned:.............................................................................................Page-01SlNo8. Equipment information, Class of station (Please tick): Fixed/Base/Repeater/Land Mobile/Walki-Talki/SatellitePhone/SNG/DSNG/TerrestrialTV/VSAT/Amateur/Paging/Trunking/SST/ISM/Data/Broadband /Broadcast/Radar/Telemetry/Cordless/Other (indicate).................9. Equipment Information:Class ofStationType/Model of Tx/Rx withManufacturer NameNo ofSetsFrequency Range Power out put, W,From To Mw, dbmClass ofemissionModulation10. Equipment Information:SlNo.Simplex/DuplexXTL/SynthesizedSource ofPower,Bat/GenB/W orChlSpacingTX/RXSeparationType ofAntennaAntennaPolarizationV/HAntennagain (dbi)Height ofAntennafrom SealevelMinimumcode speedfor Amateur11. Equipment Information: (use this page as additional if required)SlNo.Exact location of the stationwith postal addressClass ofStationLatitude Longitude Azimuth for Point topoint LinkD M S D M SRemarksP.T.OC:\Users\John\Desktop\Frequency Form.doc

Page-0212. Terms and Conditions for use of wireless equipment in the People’s Republic of Bangladesh:-i. A Log Book for each equipment must be maintained regularly.ii. The competent Authority shall physically inspect the said equipment time to time.iii. On demand of the Competent Authority the station may be closed down at any time.iv. The licenses of the wireless equipments are not transferable.v. On expiry of the scheduled works the license must be returned to the competent Authority.vi. Export and import of the wireless equipment is strictly prohibited without prior permissionof the authority.vii. A government lavvy is not chargeable for unserviceable wireless set if sealed by thecompetent authority.viii. Telecommunication facilities will be disconnected for non-payment of Govt. dues.ix. Charges on frequency, power output, station & License fees to be paid as per rate list infavor of Bangladesh Telecommunication Regulatory Commission (BTRC).13. Note:a) Appropriate Network plan to be submittedb) Technical Catalogue to be submittedc) Period for which license is required (for foreigner)d) Amateur Radio License (Local): Passport or Police Verification report to be submittede) Amateur Radio License (Foreigner): Photocopy of existing Amateur License, Passport & Visato be submitted.f) Prior Permission to be required for any coding or cipher equipment to be used.g) Name of wireless equipment if installed earlier, please state frequency, Power output & numberof sets.h) Photo Copy of up to date Vendor Licensei) Class of station means: Fixed/Base/Repeater/LandMobile/Walki-Talki/Satettite Phone/SNG/DSNG/TerrestrialTV/VSAT/Amateur/Paging/Trunking/SST/ISM/Data/Broadband/Broadcast/Radar/ Telemetry/Cordless/Others (indicate)...............14. Declaration: I under take to observe the conditions of license & here by certify that the apparatusherein described and will be worked in accordance with provision of license, I further declare that allinformation’s mentioned are true and correct. If any statement kept concealed, the BangladeshTelecommunication Regulatory Commission (BTRC) reserves the right to seize the wirelessequipment.For official useSignature of the applicant with seal & date.................... ...................................... ............................Analyzed by Checked & corrected by Countersigned by(seal) (seal) (seal)C:\Users\John\Desktop\Frequency Form.doc

Bangladesh Telecommunication Regulatory Commission (BTRC)Application Form for a Maritime/Aeronautical Mobile StationApplication for a license to establish, maintain and work wireless Communication Apparatus in Ships/Aircraft’s registered in Bangladesh.1. Name of Applicant (in block capital): …………………………………………………………………Postal Address: ………………………………………………………………………………………...(a) Name of Contact Person:..................................................................................Designation .................Mobile: …………………….. Telephone: ……………… Fax: …………… E-mail: ……………...Page-012. Particulars of ship for which a license is required:Registered No Name Gross Tonnage Owner Port of Registry3. Particulars of Aircraft for which a licence is required:Name &NumberType & MakeMaximum take offweight (kg)Registered MarkingPlace of Registry inBangladesh4. Particulars of Radio Communication Apparatus.SymbolsMFHFVHFType/ Model of TX/ RX.with Manufacturer nameAllocatedFrequency BandAssignedFrequency (s) &ToleranceNominal MaximumTransmitter Power(w)5. Particulars of Radio Communication Apparatus.SymbolsMFHFVHFMaximum AntennaGain (dbi)PolarizationV/HP.T.OHeight of Antenna fromSea level (M)Class ofEmissionBandwidthC:\Users\John\Desktop\Frequency Form.doc