consider refusing the application and the frequency may become available for assignment to other services. Applicants will be advised REASON of review and appeal rights which apply to any decision to refuse an application. Cheques or money orders should be made payable to the Australian Communications and Media Authority. Consideration of an application attracts an administrative charge, even if the ACMA refuses to issue the licence. FOR EXAMPLE: AMOUNT OF FEE CANNOT BE DETERMINED UNTIL ADVISED BY THE ACMA SEE – To avoid delays in processing, completed forms should be forwarded NOTES ON THIS FORM REGARDING PAYMENT OF FEES FOR FURTHER INFORMATION. with the appropriate fee to: Radiocommunications Licensing and Telecommunications Deployment Section Operations Branch Important notes on payment of fees: Belconnen ACT 2616 Where the correct payment does not accompany an application, the ACMA will notify the applicant of fees payable. The relevant fees are Telephone: 1300 850 115 to be paid within 45 days from the date on the notification to the Facsimile: (02) 6219 5347 applicant. Should fees not be paid by the due date, the ACMA will Email: Declaration (A LICENCE MUST BE HELD BY EITHER AN INDIVIDUAL OR A BODY CORPORATE) I declare that the information provided in this application, and in any accompanying documents, by me as the applicant, or as a person **If you are not registered with the ACMA as an accredited authorised **by the applicant, is true and correct in every detail and that person, attach copy of written agency agreement confirming that the equipment to be employed is of a type accepted by the ACMA for you are authorised to act on the applicant’s behalf in this particular licensing purposes. matter; otherwise, sign the acknowledgment below. I certify that I am authorised to act as an in relation to this application. SIGNATURE SIGNATURE PRINT NAME PRINT NAME DATE DATE NAME OF AUTHORISED AGENT’S ORGANISATION (IF A BODY CORPORATE) NAME OF AUTHORISED AGENT’S ORGANISATION (IF A BODY CORPORATE)
REASON FOR EXAMPLE: AMOUNT OF FEE CANNOT BE DETERMINED UNTIL ADVISED BY THE ACMA – SEE NOTES ON THIS FORM REGARDING PAYMENT OF FEES FOR FURTHER INFORMATION. Important notes on payment of fees: Where the correct payment does not accompany an application, the ACMA will notify the applicant of fees payable. The relevant fees are to be paid within 45 days from the date on the notification to the applicant. Should fees not be paid by the due date, the ACMA will consider refusing the application and the frequency may become available for assignment to other services. Applicants will be advised of review and appeal rights which apply to any decision to refuse an application. Cheques or money orders should be made payable to the Australian Communications and Media Authority. Consideration of an application attracts an administrative charge, even if the ACMA refuses to issue the licence. To avoid delays in processing, completed forms should be forwarded with the appropriate fee to: Radiocommunications Licensing and Telecommunications Deployment Section Operations Branch Belconnen ACT 2616 Telephone: 1300 850 115 Facsimile: (02) 6219 5347 Email: Declaration (A LICENCE MUST BE HELD BY EITHER AN INDIVIDUAL OR A BODY CORPORATE) I declare that the information provided in this application, and in any accompanying documents, by me as the applicant, or as a person authorised **by the applicant, is true and correct in every detail and that the equipment to be employed is of a type accepted by the ACMA for licensing purposes. SIGNATURE PRINT NAME DATE NAME OF AUTHORISED AGENT’S ORGANISATION (IF A BODY CORPORATE) **If you are not registered with the ACMA as an accredited person, attach copy of written agency agreement confirming that you are authorised to act on the applicant’s behalf in this particular matter; otherwise, sign the acknowledgment below. I certify that I am authorised to act as an in relation to this application. SIGNATURE PRINT NAME DATE NAME OF AUTHORISED AGENT’S ORGANISATION (IF A BODY CORPORATE)
r057-application_for_apparatus_licences.docx