Electronic Communications Act, 2005 (Act No. 36 of 2005)

Regulations

Radio Frequency Spectrum Amendment Regulations, 2021

Part IX - Annexures

Annexure A

Form A
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FORM A

 

APPLICATION TO AMEND A RADIO FREQUENCY SPECTRUM LICENCE

 

Note:
(a)Applicants must refer to the Electronic Communications Act, 2005 (Act No. 36 of 2005) ("the Act') and any regulations published under that Act with regard to the requirements to be fulfilled by applicants.
(b)Information required in terms of this Form which does not fit into the space provided may be included in an appendix attached to the Form. Each appendix must be numbered with reference to the specific part of the Form.
(c)Where any information in this Form does not apply to the applicant, the applicant must indicate that the relevant information is not applicable.

 

PARTICULARS OF LICENCE

Licence number:

 

Nature of services authorised to be provided in terms of the Licence:

 

Attach a copy of the Licence that is the subject of this application. The copy of the Licence must be

marked clearly as Annexure A of FORM A 1.

 

PARTICULARS OF APPLICANT (LICENSEE)

Full name of applicant:

 

Designated contact person:

 

Applicant's principal place of business (if different from street address):

 

Applicant's postal address:

 

 

 

Applicant's telephone. number/s:

 

Applicant's telefax number/s:

 

E-mail address of designated contact person:

 

 

PROPOSED AMENDMENT TO THE LICENCE

Set out the proposed amendment/s and attach a copy of the radio frequency spectrum Licence marked

clearly as Annexure A of FORM A2:

 

Set out the reasons for the proposed amendment/s to the Licence:

 

Proposed date on which the proposed amendment shall become valid:

 

 

UNDERTAKINGS

Provide details of undertakings (if any) and other matters which, in the applicant's view, the Authority

may need to take into consideration:

 

Attach a resolution authorising the person signing this application. The resolution must be marked clearly as Appendix A of FORM A 3.

 

The person signing the application on behalf of the applicant must acknowledge as follows:

 

I acknowledge that the Authority reserves the right to have any Licence amended pursuant to this application set aside, should any material statement made herein, at any time, be found to be false..

 

Signed ..................................................................................................................

(APPLICANT)

 

I certify that this declaration was signed and sworn to before me at ..................................................... on

the .......................... day of ........................................... 20..., by the deponent who acknowledged that he/she:

•        knows and understands the contents herein;
•        has no objection to taking the prescribed oath or affirmation; and
•        considers this oath or affirmation to be truthful and binding on his/her conscience.

 

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

COMMISSIONER OF OATHS

Name:

Capacity:

Address: