ICASA_Landmobile_App.. - Two Way Radios South Africa

Official use onlyIndependent Communications Authority of South AfricaPinmill Farm, 164 Katherine Street, Sandton, 2196Private Bag X 10002, Sandton, 2146Tel: (+27 11) 321-8352. Fax (+27 11) 321-8539Bloemfontein/Kimberley (051) 447-3001, Durban (031) 207-5000, Cape Town (021) 595-1640Port Elizabeth (041) 396-2500, Pretoria (011) 321-8200/1, Johannesburg (011) 321-8405SECTION 1: RADIOCOMMUNICATION APPLICATIONThe form must be completed in CAPITAL LETTERS,and in BLACK INKApplication TypeNumber of appendices attached A,B,C,D e.g. (1 of 20)ofType of serviceTemporary/Test Licence DateTransferNew Radio Communication ServiceRadio Communication Service ModificationExisting Licence No./FromToNew Radio Type ApprovalModify Type ApprovalAeronauticalAlarmsAmateur RadioCellularCitizen BandCivil Defence ForceCommunal RepeaterRecommendedApprovedNot ApprovedPendingWaiting ListOfficial Use Only…………………………………..Signature…………………………………..Signature…………………………………..DateDemonstrationExperimentalLink above 1000 MHzLink below 1000 MHZMaritimeLoad SheddingMessage HandlingPagingNotesOfficerDatePrivatePrivate RepeaterSatelliteShort Range Business PortableSki-BoatSpecialTelemetryTrunkingOtherSpecifyRadio Suppliers/TechniciansVehicle TrackingVery Short Range BandWan

SECTION 2: CLIENT FORMNon-citizen Information (Applicant Only)Passport No.NATIONALITY BIRTH DATE BIRTH PLACERadio Suppliers/TechniciansInformationDo you (mark where applicable)Two way Radio Communication Equipment?Supply Supply/Install Supply/Install/RepairCERTIFIED COPIES OF THE FOLLOWING DOCUMENTS MUST BE FURNISHED IF APPLYING FOR EXCLUSIVE FREQ UENCIES:1. THE COMPANY’S REGISTRATION CERTIFICATE2. IN THE CASE OF AN ASSOCATION, THE CONSTITUTION OF THE ASSOCIATIONOfficial Useonly1. Letter of authorization in respect of the transfer of existing frequencies and copy of licence attached.2. Printout of account particulars3. Map indicating the exact area of Operations4. List of licences with existing Repeater Systems in proposed area of operation who have been approached inorder to obtain frequencies.5. Number of units as specified in the Act correct.6. All documents signed and correctly completed7. Business Plan attached.8. Existing System.9. Register to indicate that existing system is fully utilized (i.e 10 clients; 100 stations)10. Existing System Paid/Not paid.11. Spectrum contentionYesNo…………………………………….. …………………………………….. ……………………………………..Name and Signature Name and Signature DateCOMMENTS FROM SPECTRUM MANAGEMENTCOMMENTS FROM SPECTRUM LICENSING

Official use onlyA P P E N D I X ANumber of appendices attached A, B, C, D (e.g. 1 of 20)ofDETAILS OF FIXED AND MOBILE TERRESTRIAL SERVICEName of Company / IndividualIf extending an existing licence, provide licence noInformation to be transmitted: Voice Data VideoPurpose of ServiceNature of ServiceOperation Simplex Duplex Name of Operational AreaFor HF Stations only:Designation of emission Hours of operation/Fromto

APPENDIX A: DETAILS OF FIXED & MOBILE TERRESTRIAL SERVICESite A InformationClass of Station(ITU Classification)Number of fixes Stations: Base / ControlRepeatersNETWORK LAYOUTCapacity / BitrateModulation SchemeEarth StationsSite A/LinkService Area/Radius in KmTotal PropagationLoss in dBSITE A: (Any Fixed Station, Base/Control, Repeater, Satellite Earth Station, Links)*NOTE: Duplicate and complete this page for each fixed stationName of Site/StationBuilding/FarmSite / StationCo-ordinates(Deg, Min, Sec)South D M SEast D M SStreet nameNo.Building Farm PlotSuburb City Postal CodeContact PersonTelephone/CellSite/Station height above Sea Level (ASL)Antenna height above Ground Level (AGL)Equipment Manufacturer and Brand NameModel No.Transmitting Power Watt dBm Effective Isotropic Radiated Power (EIRP)Watt dBmType of tone codingAntenna manufacturerAntenna Gain: Tx(dBd)(dBi) Rx(dBd)(dBi)PolarisationAntenna typeand modelReceiver sensitivity threshold(dBm)(dBuv)(uv)Antenna diameter(if applicable)Tx: Fixed/Coupling lossmFrequenciesRequiredRx: FixedCoupling loss(dB)KHz MHz GHz(Mark applicable)Number of antennaeto be used at siteCo-ordinatesof antennaeHeight of antenna centreabove ground levelSouth D M S East D M SmChannel SpacingEquipment Type Approved by ICASAYesNo

APPENDIX A: DETAILS OF FIXED & MOBILE TERRESTRIAL SERVICESite B InformationNETWORK LAYOUTSite B/LinkNumber of Stations:MobilesClass of Station(ITU Classification)Path LengthHandheldOutstations/AlarmsTotal PropagationLoss in dBCapacity/BitrateModulation SchemeService Area/Radius in KmSITE B: (Any Other Station: Mobile, Handheld, Alarms, Outstation, etc.)*NOTE: Duplicate and complete this page for each fixed stationName of Site/StationBuilding/FarmSite / StationCo-ordinates(Deg, Min, Sec)South D M SEast D M SStreet nameNo.Building Farm PlotSuburb City Postal CodeContact PersonTelephone/CellSite/Station height above Sea Level (ASL)Antenna height above Ground Level (AGL)Equipment Manufacturer and Brand NameModel No.Transmitting Power Watt dBm Effective Isotropic Radiated Power (EIRP)Watt dBmType of tone codingAntenna Gain: TxAntenna typeand modelAntenna diameter(if applicable)Tx: Fixed/Coupling lossNumber of antennaeto be used at siteCo-ordinatesof antennae(dBd)(dBi) RxmFrequenciesRequiredRx: FixedCoupling lossHeight of antenna centreabove ground levelAntenna manufacturer(dBd)(dBi)mPolarisationReceiver sensitivity thresholdChannel SpacingSouth D M S East D M S(dB)KHz MHz GHz(Mark applicable)(dBm)(dBuv)(uv)Equipment Type Approved by ICASA Yes NoAgreement by applicant (must only be signed by applicant)I/We understand that if my/our application is approved the licence will be subjected to the provisions of the Electronic CommunicationsAct, 2005 (Act No. 36 of 2005), and the Regulations made thereunder, as amended from time to time.SURNAME IN CAPITAL LETTERSCapacityDateSignature

SECTION 3:CLIENT INFORMATIONCompanyTrading NameDepartmentRegistration No.Tax No.TitleInitialsSurnameID No.NationalityArea CodeTel (B)Area CodeTel (H)Area CodeFax NoCellE-MailBusiness or Residential AddressBuilding/Farm/PlotStreet No.StreetSuburbCity/TownPostal codePostal Address if different from the abovePostal codeAccount InformationSurname of person responsible for payment of the accountTitle Initials Job Title or PositionName of branch or division responsible for payment of the accountPostal addressPostal codeArea Code Tel (B) Area Code Tel (H)Area CodeFax NoCellIf you are already in possession of the radio equipment state date on which acquiredLicence number of previous ownerName and address of previousowner

SECTION 3: CLIENT INFORMATION (continued)Next of kin: (If applicant is a private person furnish name and address of next of kin not living with you)Title Initials SurnameID No.RelationshipArea Code Tel (B) Area Code Tel (H)Area Code Fax No. CellResidential AddressPostal CodePostal AddressPostal CodeNote that should the applicant be under the age of 18 the following should be completedDetails of GuardianTitle Initials SurnameID No.RelationshipArea CodeTel (B)Area CodeTel (H)Area CodeFax No.CellResidential AddressPostal CodePostal AddressPostal Code Postal CodeAgreement by applicant (must only be signed by applicant)I/We understand that if my/our application is approved the licence will be subjected to the provisions of the Electronic CommunicationsAct, 2005 (Act No. 36 of 2005) and the Regulations made thereunder, as amended from time to time.SURNAME IN CAPITAL LETTERSCapacityDateSignature