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CPC-2-1-23- Licensing Procedure for Spectrum Licences for Terrestrial Services
Appendix A - Sample Notification of Spectrum Licence Transfer or Division
Part 1 Information to Be Completed by Existing Licensee
1.1 Licensee Name:_____________________________________________
1.2
Address:____________________________________________________
Street, P.O. Box, etc.
City, Town Province
Postal Code
Telephone Number Fax Number
Email Address
1.3 Licence Account Number:______________________________________
1.4 Summary of licence(s) to be transferred or divided:
| Licence Number | Expiry Date | Spectrum | Geographic Area |
|---|---|---|---|
1.5 Map enclosed Yes____ No _____ (Required for partitioning)
1.6 Proposed Date of Transfer or Division: __________________________
1.7 Authority
I certify that I am an authorized representative of the above-named licensee and that the information stated in Part 1 of this Notification is true and correct.
SIGNED this _____ day of __________________, in the year _______
___________________________________________________________
Signature of Applicant or Individual Authorized to Sign for the
Licensee
___________________________________________________________
Name of Applicant or Individual Authorized to Sign for the Licensee
(Please print clearly)
___________________________________________________________
Title of Person
Part 2 Information to Be Completed by Proposed Licensee
2.1 Name: ______________________________________________________
2.2 Address: _____________________________________________________
Street, P.O. Box, etc.
City, Town Province
Postal Code
Telephone Number Fax Number
Email Address
2.3 Authority
I certify that I am an authorized representative of the above-named proposed licensee and that the information stated in Part 2 of this Notification is true and correct.
I certify that I have read and I understand the contents of the eligibility criteria as set out in the Radiocommunication Regulations and that I comply with these requirements. I will comply with the criteria on an ongoing basis and will notify the Minister of Industry of any change which would have a material effect on my eligibility. Such notification will be made in advance of any proposed transactions within my knowledge.
I certify that I understand the use to which the radio frequencies, that are the subject to the spectrum licence(s), may be employed.
I certify that I have read and understand all the conditions of licence that continue to apply to the spectrum licence(s) and I certify that I will comply with these conditions.
I also understand that the Department may require additional information for the review of the proposed transfer.
SIGNED this _____ day of __________________, in the year _______
___________________________________________________________
Signature of Applicant or Individual Authorized to Sign for the
Transferee
___________________________________________________________
Name of Applicant or Individual Authorized to Sign for the Transferee
(Please print clearly)
___________________________________________________________
Title of Person
