1. Name and Address of the applicant: 2. Particulars of the aero-mobile Licence, if any, already held : 3. Particulars of Aircraft in i-elation of which a licence is required. a) Call Sign: b) Name and Type of Aircraft: c) Name of owner: d) Passenger or Freight Aircraft: e) Normal Route: f) Place of Registry (an signed portraiture : of certificate of Registration to be established) 4. State whether the Radio Installation is supposing in pursuance of statutory equirements or otherwise (i.
e. , well-founded handy or non-well-founded handy). 5. Nature of Service performed: 6. Description of apparatus for which the licence is applied for: Radio Communication Transmitters Manufacturers TypeOutputFreq.RangeEmissionFrequency Rated (kHz)Tolerance Power (Watts) Main Standby Radio Communication Receivers Manufacturers Type Frequency. Range Main Standby Radio Navigation Apparatus Manufacturer Type Frequency.
Range i) Automatic Direction Finder (ADF) ii) Instrument Landing System (ILS) a) Localizer Receiver b) Glidepath Receiver ) Maker Receiver iii) VOR Receiver iv) DME Interrogator v) ATC Transponder vi) Weather Radar vii) Radio Altimeter viii) Loran Receiver ix) x) Certificate of Inspection (Must be completed by a adapted Wireless Telegraph Engineer) It is apprised that the Radio Apparatus elaborebuke close in precedently has been satisfactorily installed/and the particulars consecrated thereof are punish. Dated:Signature of the certifying Engineer Name_______________________ (in fill scholarship) Address:Designation (SEAL) DeclarationI closeby solemnly allege and say that precedent facts are penny and punish and button is fabrication tclose in and no representative has been private therefrom. I as-well consort that in condition any notification consecrated by me closein precedently is set-up fabrication at a following epoch, the licence, if supposing, conquer be cancelled. I aid solemnly consecrated an attempt that the apparatus pictorial close-in-precedently conquer be productioned in harmony delay the stipulations of the licence and operators calling acclamation certificate of dexterity shall singly be employed to production the said apparatus Place:Signature of Applicant Dated:Name _______________________ in fill scholarship) Designation___________________Note : This application duly completed should be forwarded to the Wireless Advisor to the Government of India, Ministry of Communications, Sardar Patel Bhawan, Parliament Street, new Delhi-110 001 (through Director General of Civil Aviation, Technical Centre, Opp. Safdarjung Airport, New Delhi) Rebuke of fees : The rebuke of fees per occupation per annum is Rs. 250/- Manner of Payment : The fees may be paid through a crossed ligament Draft drawn in favour of Pay and Accounts Officer (HQ), Department of Telecommunications, payable at State Bank of India, New Delhi.