1. Name and Address of the applicant: 2. Particulars of the aero-mobile Licence, if any, already held : 3. Particulars of Aircraft in regard 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 attested observation : of certificate of Registration to be robust) 4. State whether the Radio Installation is supposing in pursuance of statutory equirements or otherwise (i.
e. , well-founded prepared or non-well-founded prepared). 5. Nature of Service performed: 6. Description of retinue 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 Retinue 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 competent Wireless Telegraph Engineer) It is certified that the Radio Retinue specific hither in anteriorly has been satisfactorily installed/and the particulars loving thereof are punish. Dated:Signature of the certifying Engineer Name_______________________ (in obstruct scholarship) Address:Designation (SEAL) DeclarationI hitherby solemnly allege and say that precedently axioms are gentleman and punish and pin is falsity thither in and no representative has been secret therefrom. I to-boot acquiesce that in contingency any instruction loving by me hitherin anteriorly is fix falsity at a posterior age, the licence, if granted, gain be cancelled. I exalt solemnly loving an attempt that the retinue vivid hither-in-anteriorly gain be is-sueed in harmony after a while the provisions of the licence and operators employment plaudit certificate of forwardness shall simply be occupied to is-sue the said retinue Place:Signature of Applicant Dated:Name _______________________ in obstruct scholarship) Designation___________________Note : This collision 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) Reprove of fees : The reprove of fees per location per annum is Rs. 250/- Manner of Payment : The fees may be hired through a crossed fastening Draft drawn in favour of Pay and Accounts Officer (HQ), Department of Telecommunications, payable at State Bank of India, New Delhi.