Equipment Certification Application

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Equipment Certification Application

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It is an offence under the Telecommunications Act, 2001, to operate, use or install any radiocommunications equipment without a Licence from the Telecommunications Authority of Trinidad and Tobago. It is an offence under the Telecommunications Act, 2001, to provide public telecommunications and broadcasting services in Trinidad and Tobago without a Concession. Instructions: One printed copy of this application must be completed and submitted with all supporting documents. 1. The following documents must be submitted with each application: a. Evidence of Type Approval certification for the said equipment (e.g. FCC, IC, etc). b. Copies of the manufacturer’s technical specifications. c. A colour brochure of the equipment is preferred. 2. Please type or write in BLOCK CAPITAL letters using a pen 3. Please submit via mail, email, facsimile or by hand to the Authority. Submit a separate application for each make and model of equipment.

A: GENERAL INFORMATION
Applicant/Company/Name/Agent Name:
Contact Information
Title:
First Name:		Last Name:
Position:
Address
Street 1:		Street 2:
City/Town		Village
State		ZipCode

Country
Telephone		Fax
Mobile Telephone:		E mail:

B: Mailing Address if different from above		Same as above:
Title:
First Name		Last Name:
Company Name:
Address
Street 1:		Street 2:
Town/City:		State

C: COMPANY INFORMATIONTION

Company Type:

If other, please specify:

Company Registration No:

Trinidad and Tobago Company Registration Number (if different from above):

Company VAT Registration Number:

Company BIR Number:

Company Registration Date

Place of Incorporation:

Registered address or principal place of business:

Street 1:

Street 2:

Town/City:

Trinidad and Tobago Registered address or principal place of business (if different from above):

Street 1:

Street 2:

Town/City:

Registered Name:

Trading or business name (if different from registered name):

Description of principal business activity of the company:

D: Details of Application

Agent representing Manufacturer:

Title

First Name

Last Name

Name of Grantee {list who manufactured the equipment}:

Manufacturer: ¹

Make: ²

Equipment Description:

Acknowledged TYPE Approvals{ FCC I.D., IC, DOC, etc}:

Model Number:

Frequency range of operation:

Bandwidth:

Class licence Category Type for device:

Maximum Transmitter Output RF Power (dbm):

Maximum Antenna gain (db):

E.I.R.P. (Watts):

ITU Class of Emission:

Other Specific Technical Operating Parameters:

¹ Manufacturer is the entity which manufactures the equipment
² Make is the brand name of the equipment

E: Brief description of how the unit will be utilised

F. DECLARATION AND SIGNATURE

I, the undersigned, do hereby declare that the information provided in this application is correct and accurate to the best of my knowledge. I acknowledge and agree that submitting an application to the Telecommunications Authority of Trinidad and Tobago does not mean that a licence will be granted, and that consideration of this application is a matter for the exercise of the Authority’s discretion acting in accordance with the Telecommunications Act, 2001. If the licence is granted, I am fully aware of all the obligations and conditions associated with the licence. I understand that in processing this application, the Authority may undertake such investigations as it considers appropriate to verify the information submitted and/or to assess the background or suitability of any person involved or to be involved in any permission or authorisation hereby applied for, and I hereby expressly consent for myself and on behalf of the applicant(s) and all such persons, to the carrying out by the Authority of such investigations. I confirm that I am duly authorised by all the relevant persons to make this declaration.

Name of Applicant

Title:

First Name:

Last Name:

Name of individual authorised to sign on behalf of company

Title:

First Name:

Last Name:

Job Title:

Date:

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