TRC/SM/ML

TELECOMMUNICATIONS REGULATORY COMMISSION OF SRI LANKA

APPLICATION FORM FOR THE ISSUE/RENEWAL OF USE OF
FREQUENCY/FREQUENCY EMITTING APPARATUS FOR LAND MOBILE
(CELLULAR) SERVICES:
(Please read the General Instruction before completing this application form)
File No : ………….…………..
General Details :-

1. Name of the Applicant (in full):

………………………………………………………………………..……………………
2. Registered/ Business Address:
…………………………………………………………………………….………………
…………………………………………………………………………………………….
3. Address of Communication (If different from 2 above):
…………………………………………………………………………….…………….
………………………………………………………………………….……………….
4. Business or Company Registration No / Passport or NIC No (if applicable):
………………………………………………………………………….……………….

5. Contact Numbers: Tel: Fax:

Email:

6. Nature of Business:
………………………………………………………………………………..……………
7. The purpose of Use:
…………………………………………………………………………………..………….
………………………………………………………………………………..…………….
( Please attach a network layout of the communication system.)

8. Expected period of Use:

From……………………………………To ……………………………………………
9. (i) Name of Contact Person:
……………………………………………………………………………………………

(ii) Designation:
……………………………………………………………………………….……………
(iii) NIC/Passport No:
………………………………………………………………………………..……………
(iv) Contact Numbers: Tel: Mobile:

Email:

( Please give details of a responsible person of your organization.This is for purpose of

obtaining technical/operational information and any other requirement of the
Commission such as renewals,inspections,sealing etc )
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Technical Details:

10. Assigned / Required Bandwidth of Radio Spectrum:

………………………………………………………………………………….………….

11. Transmitter details should be submitted as per Annexure.

Investment / Expansion Plans

12. Detailed investment and expansion plan for the next year should be submitted along
with
this form.

I/We declare that all the details given in this application form are true and correct and I/We
hereby undertake to inform Telecommunications Regulatory Commission of Sri Lanka,
immediately, of any changes to the details given in the application form or any documents
submitted herewith.

Date : …………………………… ………………….……….

Signature Signature

Seal: ………………….…… .…………………………..

Name Name

General Instructions:

 If the applicant is a Limited Liability Company, it is required to submit certified

copies of form 48, 36, Memorandum of Association and Articles of Association,
Certificate of Incorporation. This is required to be submitted by the new
applicants and only if there is any change in the documents already submitted.

 If the applicant is an individual, it is required to submit a copy of the Passport or

NIC.

 If the applicant is a firm, Business Name Registration Certificate should be

submitted. For a partnership the names of all the Partners should be submitted
with the application form.

 You may be required to furnish more information in order to the process the
application.

 The Commission may any time refuse the application or cancel and revoke the
license issued, if the applicant has submitted to the Commission misleading and
false information.
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 ANNEXURE

LAND MOBILE (CELLULER ) SERVICE

Transmitter Site Details TX/RX Frequency Details TX/RX Equipment Details Transmitter Antenna Details

Location Geographical Elevation Date of Class of Channel Tx Rx BW Equipment Make Serial TX Gain Height Polari- Type ERP
Fre. Fre.
(Address) Co-ordinates AMSL Comm. Emission No (MHz) (MHz) (KHz) Type & No Power (dbd/dbi) (m) zation (dbW)
Latitude Longitude (m) Model (W)
De Min Se De Min Se