APPLICATION FORM FOR THE ESTABLISHMENT OF BROADCAST STATION

Ministry of I & B Reference: PTA Reference: FAB Reference: Licence No: 1. Name of Applicant Organization: Postal Address: Fax No. (First Name) Designation: Tel: (with city Code): Fax: (with city Code): 3. Purpose: Audio Only: 4. 5. 6. 7. Duration of Service: Nature of Service: Mode of Operation: Site Data: a. Name of Station: b. Address of Station: c. Date of Start Broadcasting: e: Coordinates: Longitude: Latitude: f. Height of site above mean sea level (meters): g. Nature of Service: City Within 16 KM of aerodrome h. Call Sign: k. Length of Circuit: 8. Equipment Data a. Equipment Name: c. Equipment ID: e. PTA Type Approval No. f. Frequency Band proposed: g. Frequency range of equipment: h. Bandwidth: j. Designation of Emission: k. Frequency Stability (Hz): l. Type of signal code: m. Max power output of equipment (Watts): n. Average Power (Watts): o. Type of antenna: p. Precision offset: q. frequency offset: 20m Precise 8m Not Precise 0m 8P 20P
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Date: Date: Date: Date:

For Official Use Only

Tel. (with city code): 2. Contact Person: Mr/Ms/Mrs.

Web Site: (Last Name)

Department: Mobile No. (if any): E-mail: Analog TV FM 3 months Public Broadcast Digital TV SW 5 years Government Analog Audio MW 10 years Limited Public Permanent Private

Broadcast Synchronized

d. Special sign of Tx:

Degrees: Degrees:

Minutes: Minutes:

Seconds: Seconds:

Government Government j. Area of Service (Sq.Km):

Limited Public Limited Public

b. Equipment Model: b. Manufacturer:

Analog

Digital

r. TV Colour System (PAL, SECAM, NTSC): s. Vision to sound power ratio: t. TV System (G: L: I: B): u. Radiated power expressed in dBW in one of the following: - Equivalent isotropically radiated power (RR 155): - Effective radiated power (RR 156): - Effective monopole radiated power (RR 157): v. Type of Modulation: w. Multiplexing Method (Frequency Division, Time Division, Cosinus Division): x. Transfer Rate (Mbits/s): z. Bit Error Rate: ab. Horizontal Power: ad. Power at antenna input (dBW): af. Max power of equipment ourput (W): ag. Tx Frequency: aj. Sound Carrier 1: al. Frequency (Picture): an. Transmission: 9. a. Date of IFRB Notification: c. IFIC No. 10. Antenna Data: a. Antenna name: b. Antenna type: c. Antenna type approval No. d. Manufacturer: e. Antenna Gain: f. Polarization: h. Antenna height above ground level (m): j. Azimuth of max radiation: k. Elevation angle of antenna: l. Feeding loss (Antenna cable loss) dB: m. Eff. Ant. Height (Height per angle in meters): n. Eff. Ant. Height (Height per angle in meters): 11. Supplementary Information (if any): PLEASE ATTACH THE AZIMUTH/ELEVATION CO-POLARIZATION AND CROSS POLARIZATION CHARTS OF THE ANTENNA g. Polarization angle: Mono Stereo MHz ah. Ref Frequency: ak. Sound Carrier 2: am. Channel No. ao. Working Schedule (PST): b. No. of IFRB Identification: d. IFIC Reference No. Mhz y. Reliability (%): aa. Maximum radiated power (dBW): ac. Vertical Power: ae. Peak Envelope Power:

DECLARATION I declare that information provided in this application and accompanying documents is true and correct in every detail. I undertake to observe the conditions of the license, and hereby certify that the equipment herein described will be worked in accordance with the provisions of the license.
Signature: Designation: Name: Date: Office Seal
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INSTRUCTIONS The following documents must be submitted for each station: S. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. Required Documents Covering letter of company Duly completed Application Form Complete Technical Literature of the equipment Antenna pattern (Azimuth/Elevation Co-polarization and Cross polarization charts, also in graphical and tabular form) Site Plan 6-digit Sites Coordinates duly verified by the Survey of Pakistan Organizational structure of the company Name, Addresses and NIC copies of the staff Copy of the Licence with Part-I Quantity 01 Copy 14Copies 14Copies 14 Copies 14 Copies 14 Copies 14 Copies 14 Copies 14Copies

This application form shall be used for obtaining changes in any of the major features of the previously licensed installations. The major features include change of site, in already allocated frequencies, change of operating hours, change of equipment, change of type of emission. The complete application should be accompanied with a Bank draft of Rs. 600/- (rupees six hundred only) in favour of PTA as processing fee.