Guyana National Broadcasting Authority
Application for Television Broadcasting Station Licence
Pursuant to the Broadcasting Act No. 17 of 2011 If more space is needed in any of the sections, please attach additional sheet(s)
Section I - GENERAL INFORMATION Application number: TVA DATE OF APPLICATION APPLICANT’S NAME: ______(YYYY – MM – DD )
MAILING ADDRESS:
TELEPHONE #: FAX #: E -MAIL ADDRESS:
CONTACT PERSON:
TELEPHONE #: FAX #: E -MAIL ADDRESS:
Section II- OWNERSHIP
Trust Company
Name of Company / Trust ______
Company / Trust Deed # ______
Section III- CLASSIFICATION OF FILING
New Renewal Other Specify ______Continuation of Broadcasting Service Change to Authorized Station
If applying for continuation of broadcasting service state whether current/previous licence was suspended and/or cancelled and the reason(s) for such suspension and/or cancellation:______
Section IV- TYPE OF STATION
Commercial Station Noncommercial Station
Other Specify______
Applicant’s Signature - …………………………………………………………………………………….
ID or Passport Number - ……………………………………
NOTE: THIS PAGE IS TO BE FILLED OUT IN TRIPLICATE
Section V - TECHNICAL DATA 1. Frequency or channel being applied for: A. ______MHz. – Description of application:
Primary broadcasting frequency
Secondary broadcasting frequency
2. Antenna Description: Make Model number Number of sections Gain (dBi)
You are required to provide an attached copy of the radiation pattern of the proposed antenna
If the antenna utilizes beam tilt, null fill, reduced spacing (less than one wave length) between bays or the antenna is directional or specialized, an exhibit must be attached
Antenna Coordinates ______- Latitude ______- Longitude Address where transmitting facility is located:
Where antenna(s) is/are mounted on a mast/tower, state the height of the mast/tower, safety feature(s) of same and whether or not permission from the relevant authority(ies) was/were granted (state the agency(ies) that granted the permission) for the erection of the mast/tower. ______
A. Polarization: ______
B. Effective Isotropic Radiated Power (dBm):_____
C. Beam tilt effective radiated power (dBm): ( if applicable ):______
D. Azimuth (deg.): ______
E. Horizontal ERP (W):_____
F. Vertical ERP (W):______
G. Radiation center above ground level (m): ______
H. Radiation center above mean sea level (m): ______
I. Elevation (deg): ______
J. Beamwidth_E (deg):______
K. Beamwidth_H (deg):______
3. Radiation Pattern: Please attach a copy of the radiation pattern of the proposed antenna Exhibit No.
4. Transmission line description: (a) Transmission Line(s): Total losses Efficiency Make Model Number Length in meters (m) (dB) (%)
If more space is needed, please attach exhibit Exhibit No.
(b) Additional losses (Filters, Multiplexers, etc.) in transmission line system: Description Loses in dB Efficiency (%)
If more space is needed, please attach exhibit. Exhibit No. (c) Total loss in transmitter line: ______
5. Transmitter specifications:
Equipment Data Fixed Station
Make
Model No.
Power at flange (W)
System Compliance Standard (NTSC/M,
PAL, SECAM) Frequency stability (Normal, Precision,
Relaxed)
Audio Carrier Power (ERP)
Video Carrier Power (ERP)
Audio Carrier Frequency
Video Carrier Frequency
Sound Offset (kHz)
Vision Offset (kHz)
Vision/Sound Power Ratio (dB)
Nominal width of main side band (MHz) Width of vestigial side band (MHz)
Carrier noise level
Type and polarity of sound modulation
Type and polarity of Vision modulation
Audio frequency deviation
Modulation (%)
Input impedance
6. Location of Transmitter: Street Address or Location Description …………………………………………………………………………………………………………….. …………………………………………………………………………………………………………… ……………………………………………………………………………………………………………
City County Region No.
Coordinates of Transmitter: ______- Latitude ______- Longitude
7. Location of Broadcasting Studio: Street Address or Location Description …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… ……………………………………………………………………………………………………………
City County Region No.
Coordinates of broadcasting studio : ______- Latitude ______- Longitude
8. Location of Auxiliary broadcasting facility or translator station: Street Address or Location Description …………………………………………………………………………………………………………….. …………………………………………………………………………………………………………… ……………………………………………………………………………………………………………
City County Region No.
9. Geographic area – you are required to provide an Exhibit of a detailed map showing the expected coverage area of the proposed station Exhibit No.
10. Human Exposure to RF Emissions- you are required to demonstrate that the proposed station will comply with National and/or International safety limits & standards (controlled and uncontrolled) for human exposure to radio frequency emissions. Exhibit No.
A copy of the Manufacturer’s technical specifications of all the equipment (antennae included) must accompany this application.
Exhibit No.
Section VI – Technical Responsibility
(a) Planning of the Station (b) Maintenance of the Station Name……………………………………. Name……………………………….. Address…………………………………. Address…………………………….. ………………………………………….. …………………………………….. ………………………………………….. …………………………………….. Phone # …………………………………. Phone # ……………….…………... Nationality………………………………. Nationality…….…………………….
Technical Qualifications: Technical Qualifications: ……………………………………………... ………………………………………….. ……………………………………………… ………………………………………….. ……………………………………………… …………………………………………..
Applicant’s Signature Technical Representative’s Signature ……………………………………….. ……………………………………….
Date ………………………………….. Date ………………………………….
Signature of Person filling out the Form, if different from Applicant: ………………………………………………………… Date: ……………………………………
Section VII - Declaration and Signature
I, the undersigned, do hereby declare that I am duly authorized to sign this application and that the information provided herein is true and correct to the best of my knowledge, information and belief.
Name (Block Letters): ......
Designation : ......
Signature : ......
Date : ......