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APPLICATION FORM FOR THE ESTABLISHMENT OF LAND M0BILE (PRIVATE)
STATION |
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PTA
Reference: |
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Date: |
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FAB Reference: |
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Date: |
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For
official use only |
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License No: |
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Date: |
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| 1. |
Name of
Applicant Organization: |
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Postal Address: |
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Tel. (with city code) |
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Fax No. |
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Web Site: |
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| 2. |
Contact Person:
Mr/Ms/Mrs. |
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(First
Name) |
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(Last Name) |
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Designation: |
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Department: |
IT & Communication |
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Tel: (with city Code) |
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Mobile No. (if any): |
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Fax: (with city Code) |
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Email: |
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| 3. |
Purpose: |
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| 4. |
Duration of
License: |
3 Months |
5 Years |
10
Years |
Permanent |
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| 5. |
Nature of Service: |
VHF
Network |
HF
Network |
Other |
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| 6. |
Network
comprising of Base Station
Qty. |
Base Station Qty. |
01 |
Repeater Qty. |
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Mobile Qty. |
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Portable
/ Hand held Qty. |
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Total No. Of
Sites: |
1 |
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| 7. |
Site
Data (To be filled for each BASE
STATION and REPEATER separately) |
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a. Name of
Station |
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b. Address
of Station |
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c. Call
Sign |
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Area of Service (sq. km): |
500 Square Km. |
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d.
Coordinates |
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Longitude |
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Degrees. |
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Minutes |
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Seconds |
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Latitude |
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Degrees. |
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Minutes |
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Seconds |
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e. Height
of site above mean sea level (meters): |
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f. Type of
Location: |
City Hill By river |
Within 16Km of aerodrome |
Rural |
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| Note: DETAIL OF
EQUIPMENT FROM SERIAL NO. 10 TO 14 ARE REQUIRED TO BE FILLED FOR EACH TYPE |
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OF BASE
STATION, REPEATER, MOBILE AND PORTABLE IN THE NETWORK. |
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| 8. |
Equipment data: |
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a.
Equipment Name |
Motorola |
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b.
Transceiver: |
Transceiver |
Tx Only |
Rx Only |
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c.
Frequency Band: |
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d.Bandwidth |
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(KHz) |
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e.
Designation of Emission: |
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| 8.1 |
Transmitter: |
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a.
Rad.Power (EIRP) |
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(dBw) |
b. Tx
Frequencies |
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MHz |
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c. Max
Rad. Power |
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(dBw) |
d. Frequency
Band |
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To: |
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e. Output
Power |
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(dBw) |
f. Channel
Spacing |
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g. Total
Attenuation: |
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(dBw) |
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Attach
spectrum chart for transmitter |
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| 8.2 |
Receiver: |
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a.Total Attenuation (db) |
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b. Rx Frequency |
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c.
Frequency Band |
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d. Minimum Power level (dBm) |
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Page
1 of 2 |
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