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Schedule 7
APPLICATION FORM FOR A FREQUENCY AUTHORIZATION

(Regulation 17(a))

Under section 35 of the Telecommunications Act, Cap. 8.11

SAINT LUCIA

Name of Applicant __________________________________________

Type of Application ⁭ New Application

⁯ Application to Modify/Amend and Existing Licence

⁭ Application to Renew Licence

National Telecommunications Regulatory Commission

[Insert Address]

Guidance Notes

• Three [3] copies of the completed application form should be submitted in an envelope clearly marked “Telecommunications Frequency Authorisation Application” addressed to Secretary, National Telecommunications Regulatory Commission, [ECTEL Member State].

• Please note that this form may also be used for an application to modify an existing Frequency Authorisation under section 39 of the Telecommunications Act, Cap. 8.11 or for the renewal of a Frequency Authorisation under the Telecommunications Act, Cap. 8.11.

• For a renewal of a Frequency Authorisation please attach a copy of the present or existing Frequency Authorisation to the completed application form

• The completed application form must be accompanied by a fee of [ ] Eastern Caribbean dollars (EC$[]), payable to the National Telecommunications Regulatory Commission, [ECTEL Member State]. The following exceptions apply:

Radio/TV broadcast $[ ]

Community Radio $[ ]

Land Mobile $ [ ]

Special licence $ [ ]

• For questions or sections that is not applicable, write or type “NOT APPLICABLE” in bold or print.

• Please indicate which, if any, information provided by the applicant in this application is confidential.

• Please note that any word, phrase or expression used herein shall have the same meaning as it has in the Telecommunications Act, Cap. 8.11.

• The contents of this application form do not constitute legal advice. Applicants are urged to seek independent confirmation and professional advice with respect to any matter pertaining to the telecommunications licensing regime.

1. PART I - THE APPLICANT

(Please complete fully in type or block letters)

1.1 Contact Details ____________________________________

1.1.1 Name and business address of applicant _____________________

______________________________________________

Mailing address of applicant (if different from above) _____________

______________________________________________

1.1.3 Designated contact person ______________________________

1.1.4 Telephone number __________________________________

1.1.5 Fax number _______________________________________

1.1.6 E-mail address (if available) _____________________________

1.2 Business Details

1.2.1 If the applicant is a company, partnership, or other body please give the name(s) and private address (es) of each of the current directors, company secretary, or partners:

Name Address

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.2.2 State the name under which applicant proposes to trade, and registered office address if different to above:

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.2.3 In the case of a company or other body corporate, please supply the company's registered number. If not incorporated in [ECTEL Member State], please provide any registration number, which the [companies registration office] in [ECTEL Member State] may have issued.

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.2.4 Address in [ECTEL Member State] for service of process or other notices (in case of overseas applicant)

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.3 History of the Applicant

1.3.1 Has the applicant ever applied for a Frequency Authorisation or registration under any Act in [ECTEL Member State] and been refused?

[YES] [NO]

______________________________________________

______________________________________________

1.3.2 Has the applicant ever been issued a Frequency Authorisation under the Telecommunications Act, Cap. 8.11?

[YES] [NO]

______________________________________________

______________________________________________

1.3.3 If the answer to question 1.3.2 is YES, has any such Frequency Authorisation been revoked?

[YES] [NO]

______________________________________________

______________________________________________

1.3.4 Has any Affiliate of the applicant previously been granted a Frequency Authorisation under the Telecommunications Act, Cap. 8.11, which was revoked

[YES] [NO]

______________________________________________

______________________________________________

1.3.5 Is the applicant the holder of a frequency authorisation in any other country

[YES] [NO]

______________________________________________

______________________________________________

1.3.6 Has the applicant or any Affiliate been refused a frequency authorisation mentioned in question 1.3.5 above, or had a frequency authorisation revoked?

[YES] [NO]

______________________________________________

______________________________________________

1.3.7 Has the applicant operated under or carried on business under any name other than the name in this application?

[YES] [NO]

______________________________________________

______________________________________________

2. PART II - THE APPLICANT'S BUSINESS AND THE PROPOSED NETWORK AND/OR SERVICE(S)

2.1 The Applicant

2.1.1 Please provide a diagrammatic representation of the applicant's group structure, including the percentage of shares held. Please indicate which affiliates have, or intend to apply for, other telecommunications licences or frequency authorisations.

2.1.2 Does the applicant have any shareholdings of over 5% in any other licensed telecommunications provider or frequency authorization holder in the OECS?

[YES] [NO]

______________________________________________

______________________________________________

2.1.3 Has any member of the applicant's managerial staff has been bankrupt, or been a director of a company which has become insolvent ?

[YES] [NO]

______________________________________________

______________________________________________

If the answer is YES, please attach a certified copy of the discharge.

2.1.4 Has the applicant or any member of the applicant's managerial staff ever been the defendant or respondent in any proceedings in any court in any jurisdiction involving dishonesty, fraud, theft or violence, or is the applicant or any member of the applicant's managerial staff currently the subject of a charge or indictment under the law of any country for [contravention of any law or for] any conduct involving dishonesty, fraud, theft or violence?

[YES] [NO]

______________________________________________

______________________________________________

2.2 Applicant's Current Activities

Please provide answers to the following questions in relation to (a) the applicant's activities in the OECS; (b) the applicant's activities elsewhere in the Caribbean; and (c) the applicant's activities elsewhere in the world.

Networks

2.2.1 Please provide a summary of any radio-based infrastructure, which the applicant currently has in place.

2.2.2 Frequency authorisations held, including the number of frequency authorisations and the reference number of each frequency authorisation.

Services

2.2.3 Please provide details of the services currently being provided by the applicant through its existing radio-based infrastructure.

Obligations

2.2.4 Please provide details of how the applicant currently complies with any obligations in respect of harmful interference and any other emissions of electromagnetic radiation from equipment of any description.

2.3 Applicant's Proposed Activities

2.3.1 Radio communications Station

Please provide details of any Radio communications Station the applicant has in place, in addition to a summary of any radio-based infrastructure that the applicant is planning to put in place within the next [three] years.

2.3.2 Radio communications Characteristics
1. (a) Geographical location (latitude and longitude)
1. (b) Type of equipment and system (including manufacturer and model number)
1. (c) Radio frequency and direction of transmission [whether link applied for is uni-directional or bi-directional, and relevant transmission details?
1. (d) Transmission power level (Watts or dBm)
1. (e) [Preferred polarisation of emissions (i.e. vertical or horizontal)]
1. (f) [Preferred equipment carrier frequency range for channel assignment]
1. (g) [Whether system is intended to be duplicated]
1. (h) Type of antenna, including details of antenna height
1. (i) Antenna Gain (dBi)
1. (j) [Call signs]
1. (k) Address of location from where equipment is to be operated (if different from Radio communications Station location) (l) [Radio frequency feeder loss and hot-standby loss, rounded up to nearest dB. Any radio frequency feeder loss over 10 dB or hot-standby loss over 4 dB must be justified.]

2.3.3 Is the Frequency Authorisation for which the applicant is applying to be used in relation to a satellite earth station?

[YES] [NO]

______________________________________________

______________________________________________

If the answer is NO, please proceed to question 2.3.5.

2.3.4 If the answer to question 2.3.3 is YES, please provide the following information:
1. (a) A letter from the satellite provider, indicating the name and address of the satellite provider, indicating assigned frequencies for the proposed service and the station to be communicated with.
1. (b) A copy of the manufacturer's technical specification for the transmitter, receiver and antenna.
1. (c) The following information in respect of the satellite earth station Receive characteristics:
  1. (i) Make and model
  1. (ii) Assigned frequencies (downlink)
  1. (iii) Assigned frequency band
  1. (iv) Date of bringing into use
  1. (v) Location of station, including country and geographic coordinates
  1. (vi) Class of emission
  1. (vii) Antenna size, antenna gain and receive G/T
  1. (viii) Horizontal elevation angle and min/max elevation angle
  1. (ix) Azimuth
  1. (x) Altitude (a.m.s.l)
  1. (xi) Polarisation
  1. (xii) Receive noise temperature
  1. (xiii) Regular hours of operation
  1. (xiv) Maintenance of system
1. (d) The following information in respect of the satellite earth station transmitting characteristics:
  1. (i) Make and model
  1. (ii) Assigned frequencies (uplink)
  1. (iii) Assigned frequency band
  1. (iv) Proposed date of bringing into use
  1. (v) Transmitter power, including saturated transmitter power and maximum radiated power
  1. (vi) Antenna gain
  1. (vii) Polarisation
  1. (viii) Modulation (including FDM-FM, PCM/PSK, TV, and other)
  1. (ix) Regular hours of operation
  1. (x) Agreements with satellite provider
  1. (xi) Operating satellite
  1. (xii) Name of receiving earth station

Services

2.3.5 Please provide a description of the service, which the applicant proposes to provide using the frequency band for which it is applying.

Obligations

2.3.6 Please provide details of how the applicant proposes to comply with the obligations in the frequency authorisation [and in the Frequency Authorisation Regulations] in respect of harmful interference, and any other technical regulations in respect of emissions of electromagnetic radiation from equipment of any description.

3. PART III – DECLARATION2

On behalf of the applicant, I declare that the information provided by me on behalf of the applicant is accurate and complete in all respects.

Signed: _____________________________________________

Full name of signatory: ____________________________________

Post held: ____________________________________________

Date:

__________________________________________________

¹Where the applicant is located overseas, the application must include an address for service of process and any other notice in [ECTEL Member State]. 2

This declaration must be signed:

(i) in the case of an individual, by the person in whose name the application is made;

(ii) in the case of a sole proprietorship, by the sole proprietor; or

(iii) in the case of a partnership, by a partner; or

(iv) in the case of a company or other body corporate, by a director, company secretary or other authorized office.

• For questions or sections that is not applicable, write or type “NOT APPLICABLE” in bold or print.

• Please indicate which, if any, information provided by the applicant in this application is confidential.

• Please note that any word, phrase or expression used herein shall have the same meaning as it has in the Telecommunications Act, Cap. 8.11.

• The contents of this application form do not constitute legal advice.

Applicants are urged to seek independent confirmation and professional advice with respect to any matter pertaining to the telecommunications licensing regime.

1. PART I - THE APPLICANT

(Please complete fully in type or block letters)

1.1 Contact Details ____________________________________

1.1.1 Name and business address of applicant ______________________

______________________________________________

Mailing address of applicant (if different from above)

______________________________________________

______________________________________________

1.1.3 Designated contact person ______________________________

1.1.4 Telephone number ___________________________________

1.1.5 Fax number _______________________________________

1.1.6 E-mail address (if available) _____________________________

1.2 Business Details

1.2.1 If the applicant is a company, partnership, or other body please give the name(s) and private address (es) of each of the current directors, company secretary, or partners:

Name Address

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.2.2 State the name under which applicant proposes to trade, and registered office address if different to above:

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.2.3 In the case of a company or other body corporate, please supply the company's registered number. If not incorporated in [ECTEL Member State], please provide any registration number, which the [companies registration office] in [ECTEL Member State] may have issued.

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.2.4 Address in [ECTEL Member State] for service of process or other notices (in case of overseas applicant)

______________________________________________

______________________________________________

______________________________________________

______________________________________________

1.3 History of the Applicant

1.3.1 Has the applicant ever applied for a Frequency Authorisation or registration under any Act in [ECTEL Member State] and been refused?

[YES] [NO]

______________________________________________

______________________________________________

1.3.2 Has the applicant ever been issued a Frequency Authorisation under the Telecommunications Act, Cap. 8.11?

[YES] [NO]

______________________________________________

______________________________________________

1.3.3 If the answer to question 1.3.2 is YES, has any such Frequency Authorisation been revoked?

[YES] [NO]

______________________________________________

______________________________________________

1.3.4 Has any Affiliate of the applicant previously been granted a Frequency Authorisation under the Telecommunications Act, Cap. 8.11, which was revoked

[YES] [NO]

______________________________________________

______________________________________________

1.3.5 Is the applicant the holder of a frequency authorisation in any other country

[YES] [NO]

______________________________________________

______________________________________________

1.3.6 Has the applicant or any Affiliate been refused a frequency authorisation mentioned in question 1.3.5 above, or had a frequency authorisation revoked?

[YES] [NO]

______________________________________________

______________________________________________

1.3.7 Has the applicant operated under or carried on business under any name other than the name in this application?

[YES] [NO]

______________________________________________

______________________________________________

2. PART II - THE APPLICANT'S BUSINESS AND THE PROPOSED NETWORK AND/OR SERVICE(S)

2.1 The Applicant

2.1.1 Please provide a diagrammatic representation of the applicant's group structure, including the percentage of shares held. Please indicate which affiliates have, or intend to apply for, other telecommunications licences or frequency authorisations.

2.1.2 Does the applicant have any shareholdings of over 5% in any other licensed telecommunications provider or frequency authorization holder in the OECS?

[YES] [NO]

______________________________________________

______________________________________________

2.1.3 Has any member of the applicant's managerial staff has been bankrupt, or been a director of a company which has become insolvent ?

[YES] [NO]

______________________________________________

______________________________________________

If the answer is YES, please attach a certified copy of the discharge. 2.1.4 Has the applicant or any member of the applicant's managerial staff ever been the defendant or respondent in any proceedings in any court in any jurisdiction involving dishonesty, fraud, theft or violence, or is the applicant or any member of the applicant's managerial staff currently the subject of a charge or indictment under the law of any country for [contravention of any law or for] any conduct involving dishonesty, fraud, theft or violence?

[YES] [NO]

______________________________________________

______________________________________________

2.2 Applicant's Current Activities

Please provide answers to the following questions in relation to (a) the applicant's activities in the OECS; (b) the applicant's activities elsewhere in the Caribbean; and (c) the applicant's activities elsewhere in the world.

Networks

2.2.1 Please provide a summary of any radio-based infrastructure, which the applicant currently has in place.

2.2.2 Frequency authorisations held, including the number of frequency authorisations and the reference number of each frequency authorisation.

Services

2.2.3 Please provide details of the services currently being provided by the applicant through its existing radio-based infrastructure.

Obligations

2.2.4 Please provide details of how the applicant currently complies with any obligations in respect of harmful interference and any other emissions of electromagnetic radiation from equipment of any description.

2.3 Applicant's Proposed Activities

2.3.1 Radio communications Station

Please provide details of any Radio communications Station the applicant has in place, in addition to a summary of any radio-based infrastructure that the applicant is planning to put in place within the next [three] years.

2.3.2 Radio communications Characteristics
1. (a) Geographical location (latitude and longitude)
1. (b) Type of equipment and system (including manufacturer and model number)
1. (c) Radio frequency and direction of transmission [whether link applied for is uni-directional or bi-directional, and relevant transmission details?
1. (d) Transmission power level (Watts or dBm)
1. (e) [Preferred polarisation of emissions (i.e. vertical or horizontal)]
1. (f) [Preferred equipment carrier frequency range for channel assignment]
1. (g) [Whether system is intended to be duplicated]
1. (h) Type of antenna, including details of antenna height
1. (i) Antenna Gain (dBi)
1. (j) [Call signs]
1. (k) Address of location from where equipment is to be operated (if different from Radio communications Station location)
1. (l) [Radio frequency feeder loss and hot-standby loss, rounded up to nearest dB. Any radio frequency feeder loss over 10 dB or hot-standby loss over 4 dB must be justified.]

2.3.3 Is the Frequency Authorisation for which the applicant is applying to be used in relation to a satellite earth station?

[YES] [NO]

______________________________________________

______________________________________________

If the answer is NO, please proceed to question 2.3.5.

2.3.4 If the answer to question 2.3.3 is YES, please provide the following information:
1. (a) A letter from the satellite provider, indicating the name and address of the satellite provider, indicating assigned frequencies for the proposed service and the station to be communicated with.
1. (b) copy of the manufacturer's technical specification for the transmitter, receiver and antenna.
1. (c) The following information in respect of the satellite earth station Receive characteristics:
  1. (i) Make and model
  1. (ii) Assigned frequencies (downlink)
  1. (iii) Assigned frequency band
  1. (iv) Date of bringing into use
  1. (v) Location of station, including country and geographic coordinates
  1. (vi) Class of emission
  1. (vii) Antenna size, antenna gain and receive G/T
  1. (viii) Horizontal elevation angle and min/max elevation angle
  1. (ix) Azimuth
  1. (x) Altitude (a.m.s.l)
  1. (xi) Polarisation
  1. (xii) Receive noise temperature
  1. (xiii) Regular hours of operation
  1. (xiv) Maintenance of system
1. (d) The following information in respect of the satellite earth station transmitting characteristics:
  1. (i) Make and model
  1. (ii) Assigned frequencies (uplink)
  1. (iii) Assigned frequency band
  1. (iv) Proposed date of bringing into use
  1. (v) Transmitter power, including saturated transmitter power and maximum radiated power
  1. (vi) Antenna gain
  1. (vii) Polarisation
  1. (viii) Modulation (including FDM-FM, PCM/PSK, TV, and other)
  1. (ix) Regular hours of operation
  1. (x) Agreements with satellite provider
  1. (xi) Operating satellite
  1. (xii) Name of receiving earth station

Services

2.3.5 Please provide a description of the service, which the applicant proposes to provide using the frequency band for which it is applying.

Obligations

2.3.6 Please provide details of how the applicant proposes to comply with the obligations in the frequency authorisation [and in the Frequency Authorisation Regulations] in respect of harmful interference, and any other technical regulations in respect of emissions of electromagnetic radiation from equipment of any description

3. PART III – DECLARATION 2

On behalf of the applicant, I declare that the information provided by me on behalf of the applicant is accurate and complete in all respects.

Signed: _____________________________________________

Full name of signatory: ____________________________________

Position held: __________________________________________

Date: _______________________________________________

______________________________________________________

1. Where the applicant is located overseas, the application must include an address for service of process and any other notice in [ECTEL Member State]. 2

This declaration must be signed: