MINISTRY OF POSTS & TELEOCMMUNICAION

APPLICATION FOR RECIPROCAL OPERATING PERMIT

Name of applicant
Mailing address

Type of operation required
If Mobile, describe use (Land, Sea, Air)

Technical Information

1. Transmitter: Type             Manufacturer
                Serial Number
Antenna Type used
Antenna Power
Watts                            Emission
Frequency Range

2. Receiver: Type                Manufacturer
             Serial Number

3. Location of Station (where equipment is to be installed) - give full
   details. If permanently located, give County or Territory.

4. What is the Airline distance from the nearest Airport?

5. Proposed location of Transmitter if portable, Mobile or Portable Mobile

6. Purchase date of equipment

7. Proposed date installation to be completed

8. What protection do you have to prevent unauthorized persons having access
   to your equipment (station)?

9. Is station to be open to Public Correspondence?

10. Will you require payment for handling Public Correspondence?

11. Give name of owner of station (equipment)

12. Give name of station operation

13. If station is operated by an Agent, give name of Agent

14. Is new station now ready for operation?

Date                          Signature of Applicant

For Official Use Only

1. Permission grant:          Date

2. Period of validity

3. Frequency/cies assigned

NOTE: All licenses are rented for a period of one calendar year. Any change
in location of station or equipment of modification for new equipment added
must have the approval of the Ministry of Posts & Telecommunications,
R.L. All license fees must be paid in the Government Revenue and a Flag
receipt be obtained.