Application Form for Fixed apparatus licence(s)

General Instructions

1. Applications for apparatus licences are made in accordance with section 99 of the Radiocommunications Act 1992.
2. Before filling out this form, please read these general instructions. If you are unsure how to complete any part of the application form, please refer to the Guidance Notes attached to this application form.
3. Please print clearly. Illegible, unclear or incomplete application forms may delay processing or forms may be returned for completion.

Applicant’s Details

• Customer Number: *
• Name (or contact name if an organisation): *
  • GIVEN NAMES
  • FAMILY NAME
• Organisation Name: *
• ABN: *
• Industry Type: (Description of main business activity; e.g. Construction, Mining, Manufacturing)
• Entity Type: (Description of entity type; e.g. Individual/Sole Trader, Local Government)
• Contact Details:
  • BUSINESS PHONE:
  • MOBILE PHONE:
  • FACSIMILE:
  • EMAIL:
• Residential or Business Address:
  (IF NO POSTAL ADDRESS IS PROVIDED, THE RESIDENTIAL OR BUSINESS ADDRESS WILL BE TAKEN AS THE POSTAL ADDRESS AND THE ABOVE MENTIONED DISCLOSURE PROVISIONS WILL APPLY.)

Application Type

• (** ) New service**

Licence Details

Licence Sub-Type:

• (** ) Point to Multipoint**
• (** ) Point to Point**
• (** ) Temporary Fixed Link**

Payment of Fees

• Licences issued for periods up to, and including, one year must be paid for in full at the time of application. Licences issued for longer periods may be paid for in full at the time of application, or by annual instalments. Further details about payment options can be found in the ACMA’s Apparatus Licence Fee Schedule.
• I wish to pay for the licence in full.
• Important notes on payment of fees:
  • Cheques or money orders should be made payable to the Australian Communications and Media Authority.
  • I wish to pay by annual instalments.

Service Details

• Callsign:
• Operation: (not required for Point to Point (900 MHz STL licences)
• Description of Service:
  • (** ) Simplex (one frequency)**
  • (** ) Duplex (two frequencies)**
• Nature of Service:

Station Details

• Site Address and Coordinates
• Postcode:
• Zone: *
• Easting: *
• Northing: *
• Map grid coordinates (NOT REQUIRED IF ITEM C COMPLETED):
• Coordinate system used: (TICK ONE)
  • c AMG66
  • c AGD66
  • c GDA94
  • c WGS84

Spectrum Details

• Operating Frequency:
  • Transmit: *
  • Receive: *
• Tuning Range of Equipment:
  • Transmit: Lower frequency / Upper frequency
  • Receive: Lower frequency / Upper frequency
• Emission designation: *

Equipment Details

• Operating Mode:
  • c Transmitter
  • c Receiver
• 3 dB Beamwidth: *
• Gain: *
• Antenna Details:
  • Description: *
  • Polarisation: *
  • Tilt: *
  • Height above ground: *
  • Azimuth: *

Declaration

• SIGNATURE:
• PRINT NAME:
• DATE:
• NAME OF AUTHORISED AGENT'S ORGANISATION (IF 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.

Guidance Notes

A fixed licence is issued for stations that:

• are located principally at fixed points specified in the station's transmitter licence; or in an area specified in the licence; and
• are operated principally for communications with stations located at one or more other fixed points specified in the licence; or in an area specified in the licence; and, if permitted by the station’s transmitter licence, may communicate with:
  • an aircraft station, but not on an aeronautical frequency
  • a ship station, but not on a maritime frequency
  • land mobile station, but not on a land mobile frequency.

Applying for multiple licences

If you wish to apply for multiple licences of the same type, please print multiple copies of this form and complete the relevant sections.