APPLICATION FORM
FOR RADIO FREQUENCY ASSIGNMENT
AND GUIDANCE FOR FILLING IT

www.citc.gov.sa ( -) - .
P.O Box : 75606 Riyadh 11588 Saudi Arabia Tel (966 -11) 4678000 Web Site : www.citc.gov.sa
()


  

A Applicant Information

............................................................................................................................. :



  

1- Name of Applicant: ....................................................................................................................................

......................................................................................................................................... :

 


2- Address : ....................................................................................................................................................

3- P. O. Box : ...................... 4- City : ........................................

................................... :   ........................ :

5- Region : .......................... 6- Zip Code : ..................................

............................ : !"
#$%


7- Responsible Department

.................................................................... : +,- '( )* &

8- Contact Person : ......................................................................

............................................................ : /+2*

9- Phone No. : .............................................................................

....................................................................... : 42

5( 3

10- Fax No. : ...............................................................................

..................................................................... :

11- E-Mail address : ....................................................................

.......................................................... : :;<=
> "
 ? 

......................... :  

/01$  .

789
5( 
6

     

B - Application Information

1- Purpose of Frequency Usage: .................................................

................................................... :

2- Usage Period : From ............................ To ..........................

.........................

3- Zone of Use : .........................................................................

.............................................................. :

4- Purpose of Application:
New
Modification

 . 

D ))<
@ - , A$ B%C


E .............................. A$ : @ -,> '$ 

@ -,> $ 
: FG
A$ B%C


Suppression

()

(   !" )  
   

C Radio Service Information

1- Type of Service : .............................................................

......................................................................... : $H IJ 

2- Nature of Service : ...........................................................

...................................................................... : $H K L 

3- No. of Fixed Stations : ......................................................

............................................................. : ,MN
DO )? 

4- No. of Mobile Stations : ...................................................

............................................................ :

5- No. of Stations in Microwave Network : . .............................

........................................................ : 4;;%=K DO$ )? 

6- Communication Type :. .........................................................

................................................................... :

7- Class of Operation : . ..............................................................

....................................................................... : PKCQ,
IJ &

8- Mode of Operation :. ..............................................................

....................................................................... : PKCQ,
RS .

9- Hours of Operation :. ..............................................................

.................................................................. : PKCQ,
D? 3
.......................

From (Local Time) : To : ............................

G, DO )? 

D>+2> IJ 

E ............................... A$ ( UGV WK5,

M)
&' $%     !

D - Fixed Station Information

1- Transmitting Station Name .....................................................

.................................................................. /(* Y  

2- Receiving Station Name .........................................................

................................................................ / ,> Y  

3- Geographical Coordinates For the station Site

V ]5 K\ %C DKZ [* 

................................... B%
R^ ...................... /
R^
.......... ................................... bK\ D ))%2 `K+a G _

#2cdeK$ .................................................................................

Longitude ............. E ........... ; Latitude ............. N ..............

4- Desired Frequency Band of the Required Frequency..

Transmit
()*
.................................
.................................
.................................

Receive (+&

.................................
.................................
.................................

#2cdeK$ /#2cd GK8 ...................................... ))<

_J B%? 
.......................................................................... g
IJ 

5- Necessary Bandwidth .......................................... KHz/MHz

6- Class of Emission

..

7- Channel Capacity. Mbps

8- Output Power Watt / dBW
9- Tx/Rx Separation ..MHz
10- Frequency Stability .......................................................... .. %
11- Permissible Interference ................................................ dBW

KJZ/WKMeK$ ........................................................ @h

 &
D ; P 1) ........................................................... i%H '(5 .
#2cdeK$ ................................ / ,> ; /(* !))%2 kM Pj9
3
% .................................................................. ))%,
( %, 
6
D ; P 1) ................................................ bM mn1 P^ ,


()

12 )%34 /)0 $% -.  ,

E - For Satellite Earth Station

12- Space Station Orbital

Geo.

WMZ cq

Kop9
V ( $ 

t................................. ;r s ......................... U

UZ [*
................................................................ Kop9
V 

Non Geo.

Longitude ............................. E or .................................... W

Spase Station Name .
13- indicate by sign () and degree of the elevation angles of the
Horizon in 5 degrees steps (azimuth) beginning from true North.

Horizon
Angle

Horizon
Angle

WMZ

{ D u() 7 z P 8  ? x \y I 92(  ; w () '( v* ;  u(
M F, 8r 

. ( { %C ) UK /nQ
A$ }~M U\y |e2>

Horizon
Angle

Horizon
Angle

Horizon
Angle

Horizon
Angle

60

120

180

240

300

65

125

185

245

305

10

70

130

190

250

310

15

75

135

195

255

315

20

80

140

200

260

320

25

85

145

205

265

325

30

90

150

210

270

330

35

95

155

215

275

335

40

100

160

220

280

340

45

105

165

225

285

345

50

110

170

230

290

350

55

115

175

235

295

355

&' $% 678    5

F - Antenna Information For Fixed Stations

Uo 
Kd R 

P 1) ............................................................ Uo  F18 

P 1) .................................. v% ; Uo 
C2 R^ U\ 9


<$ .................................................. B(y  A? I92(> 
&
<$ ...................................................... %O
 A? I92(> 
.
u() ....................................... U1Ko%
IQG
U\y |> ; w 
3
u() ................................................................ I92(> ; w 6
.................................................................. ,* IJ 

............................................................

14- Antenna Directivity Pattern : ................................................

15- Antenna Gain : ................................................................ dB
16- Antenna Feeder & Filter Loss : ...................................... dB
17- Height above Ground Level :........................................... m
18- Height above Sea Level : ................................................. m
19- Azimuth of the Main Lobe : .......................................... deg.
20- Elevation Angle : ........................................................... deg.
21- Polarization : .........................................................................

()

1&% $%    9

G - Mobile Station Information

1- Station Name : ........................................................................

........................................................................

2- Type of Mobile : .....................................................................

..................................................................

O  

G, V IJ 
.......................... G, V   2% ?
V ]5$ DKZ [

3- Geographical Coordinates For the Base station operating with

the mobile station. ......................................................................

...................................

Longitude ............. E ........... ; Latitude ............. N ..............

B%
R^ ...................... /
R^

.................................... bK\ D ))%2 `K+a G _


#2cdeK$..................................................................................

4- Desired Frequency Band of the Required Frequency .......

TX Frequency
.................................
.................................
.................................

RX Frequency
.................................
.................................
.................................

5- Tx/Rx Separation : .. MHz

6- Necessary Bandwidth : KHz/MHz

#2cdeK$ ............................... / ,> ; /(* !))%2 kM Pj9


#2cdeK$ /#2cd GK8 ........................................ ))<
_
B%? 
g
IJ &
D ; P 1) ............................................................ i%H '(5 .
......................................................................... Uo  IJ 3
P 1). ........................................................... Uo  F18 
6
............................................................................

7- Class of Emission :..

8- Output Power : ...Watt / dBw
9- Antenna Model : ............................................................. .
10- Antenna Gain : . dB

_____________________
FG
@$ ]K52
(,

__________________
Signature of Applicant
Date

,H Stamp

()

GUIDANCE FOR FILLING THE FORM

The applicant shall fill in all the fields of the form in

Arabic and English, and in the case of fields not
applicable to the particular service required (N/A)
shall be filled in.

          
 
 !    "# $   %  & '()
. ( $ , ) .  

 

. 

  F,8

. G F1[ D$G $

   

. ))<
@ -, A$ B%C
mM AKM

.K\ ))% ,
@  -,>  MG '  AKM

. @ -,> $ )[

FG
A$ B%C
)[

-
-

Radio Service Information

(   !" )  
  

Insert one of the following numbers to

indicate the type of service :

:  $ H I J k  ,

   n5( F, 8r

A-

Applicant Information

1-

Write the name of the Applicant .

2-11

Fill as appropriate .

B-

Application Information

1-

34-

Clearly indicate for the purpose of using the

frequency.
Indicate the period for which the frequency
is requested.
Indicate the area of use
Indicate the Purpose of the Application

C1-

2-

101.1
101.2
101.3
102.1
102.2
103.1
103.2
104
105
106
107
108
109
110
201
202
203
204
205
206.1
206.2
207
208
209

G,$ % $^

6

G,$ u $^ 
6

G,$ K(r $ ^ 
6

,MZ $? $^

6
,MZ j^ $^ 
6
K2j ?  $^

6
KJ#9G2 ?  $^ 
6
) ( [$ $^
6
) %
M ]5 $ AKK2 $^
6
) %
G9
G? $^
6
'  d $^
6&
W 5
'(v; KK5 D ))%2 $^
6.
 )j(y D ?1$ $^
63
j^ $^

6
K?+
(n5y "?  G,$ $^ 6

K?+
(n5y "?  G,$ % $^ 6
K?+
(n5y "?  G,$ u $^ 6
K?+
(n5y "?  G,$ K(r $^ 6
K?+
(n5y "?  ,MZ $^ 6
K?+
(n5y "?  K2j ?  $^
6
K?+
(n5y "?  KJ#9G2 ?  $^ 6
K?+
(n5y "?  % $^ 6&
K?+
(n5y "?  ' d $^ 6.
(n5y "?  W5
'(v; KK5 D ))%2 $^ 63
K?+

Maritime mobile service

Aeronautical mobile service
Land mobile service
Public fixed service
Private fixed service
Sound broadcasting service
Television broadcasting service
Radio navigation service
Radiolocation service
Radio astronomy service
Amateur service
Standard frequency and time signal service
Meteorological aids service
Special service
Mobile-satellite service
Maritime mobile-satellite service
Aeronautical mobile-satellite service
Land mobile-satellite service
Fixed-satellite service
Sound broadcasting-satellite service
Television broadcasting-satellite service
Radionavigation-satellite service
Amateur-satellite service
Standard frequency and time signal satellite
service
()

210
211
212
213
214
2-

K?+
(n5y "?  B(y )( $ Q,8 $^
K?+
(n5y "? )j(y '?1$ $^
Kop9
y $^
Kop\ PKCQ2 $^
K?+
(n5y AKM /+2> $^

Earth exploration-satellite service

Meteorological aids-satellite service
Space research service
Space operation service
Inter-satellite service
Select one of the following abbreviations
to indicate the nature of service :
CO - Station opens exclusively to official
correspondence.
CP Station opens to public
correspondence
CV - Station opens exclusively to
Correspondence of a private
agency.

: $H K L K,

|J)r K  D (+,^> A$ k\%[ <^r

If other nature of service is relevant, explain

under additional information ( e.g.
navigation system, meteorology . . ) .

D$G$ W
; %^r B %qy @-,12 V WJ8 
(. . . .  )j(y ;r [ @h
N$ ) K\

.R\ K%
D %nG
@-,12 V r ;

- CO

. $
D %nG
@-,12 V r ;

- CP

. R\ jH D %nG
@-,12 V r ;

- CV


6










. G, DV )?; ,MN

DV )? AKM

Indicate number of stations. Fill in for each

station. For more than 2 stations attach
routing plan.

%N8r WJ8 ; . Y P8 D$G$ 0 ,M 5; DV )? %8r

. MG D ))<
@ -, R _\( KG? k,Y A$

6-

Mention the type of communication:

(Telephony- Data transmission video . . .,
etc ).

: /+2> IJ AKM

. ( .... '(j  DJKM P %2  j ) PN$

7-

Insert A or B:
A - Regular operation and use.
B - Occasional or standby use .

:    L i ;r  ;r r % F,8r
.@h ,JM PKC Q,G

-
. D <\ G? PKCQ,G
-

8-

Insert A1 , A2, B , C, D , or E :
A1- One way operation (transmitting only,
e.g. Broadcasting).
A2- One way operation (receiving only,
e.g. navigation, direction finder, etc.) .
B- Duplex Operation.
C- Semi Duplex Operation .
D- Simplex Operation.
E- Simplex Operation with two
frequencies.

: K2 ;% [r F,8r

.( ? * PN$ R\ /( )  [ ; |M PKCQ2 -:

3-4

Indicate the number of Fixed Station and

Mobile Station.

5-

; [ N$ R\ / , ) [ ; |M PKCQ2

. ( . . .|>
.i;)#$ PKCQ2
.i;)#$ 4+J PKCQ2
.)%9$ PKCQ2
. A))<M )%9$ PKCQ2

()

;


!
 ,

9-

Use the following code :

H24 For 24 hours (Indicate the number of
Hours).
Hg For Daylight.
Hn For Night time.

:  K
 ,
w$%
@-,
.( D?1
)? AKM ) ?1
( $ G? PKCQ,G
=;<

Select the period given in 24 hours mode in

local time.

. GV WK5,
M; ?  
/^ MG '  <^r

. ( 
~Zr PKCQ,G

. P KG
~ Zr PKCQ,G

>=
(=

.&' $%   

. /(*  Y  F,8r

. / ,>  Y  F,8r

Indicate the geographic coordinates of the

station location

. V ]5 K\ %C DKZ [* )[

4-

Please indicate the desired frequency band

and frequencies pre-assigned to you .

D ))% ,
%8r bK\ D ))%2 `K+a G ))%,
_ J %8r
.xM1
A$ =
++-

5-

Indicate the bandwidth, of the required

frequency.

.G ))<
_J B%? AKM

6-

Indicate the channel capacity in (Mbps).

.(KJZ/WKM eK$) @-,1 @h

 AKM

7-

Refer to the table of

EMISSIONS attached .

. x\% g
IJ /;u E Iu%
u%

8-

State the TX output power .

. /(* wu i%^ '(5 AKM

9-

Indicate Transmit / Receive frequency

separation

. / ,> ; /(* ))%2 AKM Pj9

;

10-11

Fill as appropriate .

E-

For Satellite Earth Station

12-

Indicate whether Geostationary or NonGeostationary satellite. If Geostationary,

indicate the longitude on which the Satellite
is positioned and whether it is West or East.
Indicate also the name and designation of
the Satellite.

%n
8 \ . > @r (   WMZ U?+
%n
8  $ A KM
% n
b  KG? ] ; !
/ 
R ^ A KM (   WM Z U? +

    ;   pr .   M% q @r  5%v  8    n?   O$ U? +

. U?+
%n

13-

Please indicate by sign () and degree of

the elevation angles of Horizon in 5
degrees steps ( azimuth ) beginning from
the North .

7n  ^ P 8   ? x  \y I 92(  ; w () '( v* ;  u(
M F ,8r
. ( { %C ) UK /nQ
A$ U\y |> { Du()

F-

Antenna Information For Fixed Stations

&' $% 678  

D-

Fixed Station Information

1-

Indicate name of the transmitting station.

2-

Indicate name of the receiving station.

3-

CLASS

OF

. G F1[ D$G $

12 )%34 /)0 $% -.

()

. Uo  Kd R _\( ,

. Uo  F18 nK5 ;

Indicate the loss of the feeder & felter

between transmitter output and antenna
input.

; / (* w u i%  ^ A  KM  v% ;   C  9

n  K5  ;
. Uo 

Indicate the height of your antenna above

the ground level ( height of mast or house
plus antenna support ) .
Indicate the height of your antenna above
the Sea level .

/#  ;r !( +
I  92( ) B(y    _ \ Uo   I  92( A  KM
. ( Uo  $?) /L bK
 \p$

.%O
 _\ Uo  I92( AKM

: R\  u DKo  G

14-

Attached the antenna directivity pattern.

15-

Indicate the used antenna Gain.

16-

171819-

Only for Antennas with directivity :

Indicate the azimuthally direction of the
main lobe of your antenna relative to the
north direction .

. / nQ
|>  1
M Uo G
U1Ko%
IQ
| A KM

20-

Indicate sign (+ or -) and degrees of the

elevation of your antenna.

. Uo G
Kr%
 ; #
n K5
8; (  ;r + ) $? F,8r

21-

Complete as required.

. G Pn8r

G-

Mobile Station Information

1&% $%   

1-

Put the wanted call name .

. |(,a !
V  F,8r

:

2-

Choose the appropriate :

a. Car.
b. Aircraft.
c. Ship.
d. Other Indicate :

: F <^
.'(K  r
.'%oL  
.K9  i
. ( K,
u% ). . . .% ^r  )

3-

Indicate the geographic coordinates for the

base station

. ?
V ]5 K\ %C DKZ [* )[

4-

Please indicate the desired frequency band

and frequencies pre-assigned to you .

D ))% ,
%8r bK\ D ))%2 `K+a G ))%,
_J %8r
. xM1
A$ =
++-

5-

Indicate Transmit / Receive frequency

separation

. / ,> ; /(* ))%2 AKM Pj9

;

6-

Indicate the required bandwidth.

.G ))<
_J B%? AKM

7-

Refer to the table of

EMISSIONS attached .

. x\% g
#$( /;u E Iu%
u%

8-

State the TX output power .

. /(* wu i%^ '(5 AKM

9-

Attached the antenna directivity pattern.

. Uo  Kd R _\( ,

10-

Indicate the used antenna Gain.

. Uo  F18 nK5 ;

:@

CLASS

OF

()

    
Frequency Spectrum Affairs

CLASS OF EMISSIONS
FIRST SYMBOL
TYPE OF MODULATION (1. symbol)
Unmodulated carrier
Amplitude modulated main carrier :
* Double sideband
* Single sideband, full carrier
* Single sideband, reduced or variable level carrier
* Single sideband, suppressed carrier
* Independent sidebands
* Vestigial sideband
Angle-modulated sideband
* Frequency modulation
* Phase modulation
Main carrier is amplitude and angle-modulated,
Simultaneously or in a pre-established sequence
Pulse emission;
* A sequence of unmodulated pulses
* Modulated in amplitude
* Modulated in width/duration
* Modulated in position/phase
* With angle-modulation of carrier during pulses
* Other pulse modulation methods or combinations
Hybrid modulation systems not covered above,
involving two or more basic modulation techniques
Other cases

SECOND SYMBOL
NATURE OF MODULATING SIGNAL(2. Symbol)
No modulating signal
A signal channel of quantized or digital information
* Without the use of sub-carrier
* With a sub-carrier
A signal channel containing analogue information
Two or more channels containing quantized or digital information
Two or more channels containing analogue information
A composite system containing both analogue and digital channels
Other cases

FOURTH SYMBOL
DETAILS OF SIGNAL (4. Symbol)
Two-condition code with elements of differing
numbers and/or durations
Two-condition code with elements of the same numbers
and duration without error-correction
Two-condition code with elements of the same numbers
and duration without error-correction
Four-condition code in which each condition represents
a signal element (of one or more bits)
Four-condition code in which each condition represents
a signal element (of one or more bits)
Multi-condition code in which each condition or
combination of conditions represents a character
Sound of broadcasting quality (monophonic)
Sound of broadcasting quality (stereo or quadraphonic)
Sound of commercial quality (excluding categories
given in the next paragraphs)
Sound of commercial quality with the use of frequency
inversion or band splitting
Sound of commercial quality with separate frequencymodulated signals to control the level of demodulated signals
Monochrome
Colour
Combination of the above
Cases not otherwise covered

Code
N
A
H
R
J
B
C
F
G
D

P
K
L
M
Q
V
W
X

Code
0
1
2
3
7
8
9
x

THIRD SYMBOL
TYPE OF INFORMATION TRANSMITTED
No information transmitted
Telegraphy-for aural reception
Telegraphy-for automatic reception
Facsimile
Data transmission, telemetry, telecommand
Telephony (including sound broadcasting)
Television
Combinations of above
Other cases

()

Code
N
A
B
C
D
E
F
W
X

FIFTH SYMBOL
NATURE OF MULTIPLEXING (5. Symbol)
None
Code-division multiplex (Incl. bandwidth expansion
techniques)
Frequency-division multiplex

Code
A
B
C
D
E
F
G
H
J
K
L
M
N
W
X

Code
N
C
F