‘UG AHR / Government of India ‘Wan Hae / Ministry of Communications qatar faut / Department of Telecommunications ‘dare actor Wa WAI HEY / Wireless Planning and Coordination Wing 6% Floor, Sanchar Bhawan, 20, Ashoka Road, New Delhi-110001 No. P-14031/02/2021-COP Date: 08/11/2021 MEMORANDUM. ‘Subject: Declaration of result of the RTR (Aero) examination held at Mumbai during 27 September 2021 to 24 November 2021 - reg. ‘The following candidates, as detailed below, have been declared successful in the RTR(Aero) examination held at Mumbai during 27% September 2021 to 2! November 2021. 2. _ List of successful candidates in the RTR (Aero) - Full examination: S.No. | Roll No. Name of candidate Seer 2 SAKSHI CHAWAN ae Z ib al 7 RAJEEV HORA, | 14 | ANK MEHTA 4 7 SHIRAJ THABARE 3 2 VIJAY MESBA SHAH 6 24 KUNAL JADHAV 7. Ea ROHITSANVATSARKAR 8 38 TANVIJOSHI ° 31 DEEPAK DEWAN a] 10 33 ISHAN VINAY DUBEY | Te 35 PRANJAL SANJAY SHARMA 2 B NISHANT SABLANIA 1B 57 ASIF IQBAL CHAUHAN 4 62 | RAGHUNATH REDDY POLEPELLY "ss 15 66 KSA KHAN Hiss TI TES ISHA DEVKULE 17 | 76 | SHIVAMKUMAR se 18 77 ‘SIDDHART CHATURVEDI _ 19 79 SHRAVANIKHAVANEKAR 20 80 GITIKA DASWANT ae | 21 82 | VIVEKSOOD jaa | 22 33 DIVYA DHARMENDRA ARYA Eas 84 SHANTANU SANDEEP VARTAK Onkarc talte _ Page 1of 14 OSI -ROR!2 8 RIJUL AMEFT JOSHI 5 90 GRISHMA RANE | 26 4 TIRTH PATEL [=a 5 SAGAR RADHAKRISHANAN, 28 96 ROHAN SHASHIDHARAN 29 99 ADITYA HULGERI | 30. 105, MANAS POPHALE 3L 109 | ASHISH YADAV. 32 un RUSHIKESH KHORE 33 16 PRITI DEDIA | 34 18 AMAN MALAKAR is | 35. 12 SUSAN D'SOUZA } 36 126 ADITYA DATTA 37 127 SIDDHARTH GANESH, 38. 128 ADVAIT JAYAPRAKASH. 39 129 MANIL SINGH 40 130 JEEVET DONGRE 41 133, ABNINDER SINGH | = 134 MOHIT SHARMA | Cs 137 AAKASH SHINDE Ce MI ‘APOORVA ARINGUNDRUM SRINIVASAN. I 45 4151 AMAN SINGH CHANDEL 6 154 AKASH VENKATESH MACHAKANUR a7 166 RANJITH RAJESH 48 170 NISHAD KHADSE 49 174 BHUMIKA PAWAR 4 50 185 ‘AMRIT KHUNTIA, a 186 DANISH WARSI faa 189 SAKSHI DAS 53 191 TANYA YADAV a4 192 ROHAN SETIA. 55 195 ‘ABHAY VASANT PATIL 56 205 PRANAI PRASANNA = 57 217 SAKHSHI GAJANAN BODHE 38 219 KRUNAL PRAJAPATI 59 21 ‘APURVA SAKPAL 60 224 VISHAK KUMAR VERMA 61 229 ‘YASH PAREKH eo 62 242 KANWARJEET SINGH 63, 244 ROHIT TART ot 254 SANDEEP RAT a 65 263 SOMNATH SOPAN MANE. 66 268 ABHIDEEP KUMAR | 67 274 YASHVI LALWANI Le 275 NEHA SONDHIYA ] ontkec (NOMe Mase 20a = Page 2 of 14T6 GAURAV KUMAR 279 KIRTI TIWARI 282 ADITYA BAKSHI 286 NIKITA SAHU 287 RAHUL RAI 288: VIKAS RISHT 289 SURAJ.MS 296 SAYANATAN CHAKARAVARTY 301 ALPAJADHAV, 303 ASHI KANHERE 305, VISHAL TURE 306 ANKIT AGARWAL 310 VIKAS SACHAN, 314 RAVINDER KUMAR 316 TISHA RAO’ 317 ‘AJITH B NAGAVI ] 320 PRATIK KUMAR | 325 SHEETAL GHONGTE | 328 PANKAJ PADURANG CHAVAN 330___[ HIMMER RAITHATHA | 335 VIKRANTSSHINDE | 338 DIKSHITA JAIN | 350 YATHARTH 351 UJJAWAL PANWAR 359 SAGNIK KAR 360) NEVINBENNY | 362 SWARNIM DDT 363 MEHAK SHARMA 2 367 MUUNA KUMAR 368 VEDANT KAKADE 371 | YASH CHUGHA 372 RACHNA NAIR 378 NAVYAA PAHWA. 380. SAKSHI KAPOOR 384 ABDULLAH SHAIKH 386 PRANAY GOPINATH 105 387 ‘AAKASH MAHAJAN 106 388 | JYOTICHAVAN 107 391 RAVI DUBEY 108 393 NAVNEET 109 396, SHIVAM KUMAR 0 397, KEVIN JOHN 11 405 MAYURIGHORAD- 112 406 SRIDHAR STALIN KUMAR, 13 411 ARSALAN KHAN Oxkac (Vath bale 0g - 11 -ROZ!4 12 YASHWANTH SAI KASINA. 115 417 SHUBHAM RASAM 116 422 SOORAJ BISHNOI 117 433 KARTHIK PANIKAR ] us 434 SANDEFP SRIDHARAN 119 435, ARUN SINGH NARUKA a 120 436 VITHAL DEVIDAS SHINDE iz 238 VINAY SHUBHASH NAGALE 1 29 ARIJIT SARKAR, L 13 440 SHUBHAM SINGH PAWAR, [i 445 RACHANA BEN PATEL [_as. 446 BHARGAB KUMAR BARUAH me. 448 ANAM JOSHI 1277 451 KIRAN PEM BARTHI 18 4 SHREYA SINHA 129 457, PRATIK BABURAO SHINDE 130. 459 PALAK RATHOD [ar 461 SANKET BURAMBADKAR 132 464 VIVEK YUVRAJ HINGE [338 470 DANIELLE JOAN HUGGINS eal [134 485 PAVAN KORU z | 135 487 B. RAVIKUMAR 136 492 SIDDHARTH SHUKLA 137 493 VIJAYKIRTI RISHISHWAR 138 500 MIT MOHINDRA_ 139 501 MUSKAAN AMINA BASHIR SHAIKH 140 503 YASHIKA ACHYUT TALAVADEKAR 141 510 RONAK M. KHOKHANI 142 514 KARAN MANOJ BHANDARI 143 521 ADITYA RAJESH LADDHA. 144 524 DINESH VIJAYPAL UJINWAL_ 145 535 VIGNESH S | 146 536 SANDEEP KUMAR. 17 543 SAHARSH DIXIT [148 344___| SNEHA PATEL 149 545 | SHUBHIAM KATARIA | 150 546 ASHWIN SHIBU THOMAS i 151 548 STIVAN NARWAL 152 553 SINGH KUNDAN TARAKNATH 153 554 ‘SHEFEEK NAZEEMUDEEN 154 555 JOLIZA BOLVI RODRIGUES z 155, 557 JAYGANESH THEVAR, 156 558 DHEERAN BAKTHAVATCHALAN 157 560. FAZILA NAAZ KHAN 158 567, JASON JOSEPH PAVAN oe, to Me OS- RO} Page 4 of 14159 571 AKASH SAHA 160. 374 | GAURANG PATEL 161 575, CHITWAN AGARWAL 162 579 ‘ANUSHKA BHUSHAN 163 581 RAJESHREE DAS Tod 584 ROSSIL MILTON GONSALVES 165 588 PRITI PRALHAD MUNDE 166 594 D SHRIDHAR PURUTE] REDDY 167 602 PRACHI SAWALKAR 168 605 ‘SUMIT KUMAR 169 610 GAYATREE S. APHALE 170 618 YASH SONKAMBLE al 62 TANYA JAIN 172 (624 UPKAR SINGHR. YADAV 173 625 ABHIMANYU NARENDRA KAPAM 174 633 CHARVIJADHAV 15 637 ‘AMITESH UPADHYAY 176 638 NITIN MORESHW AR PARATE. 177 640 SAHITYA PUNDIR- 178 645, HEMIN J PUNADIYA 179 _ 656 VATHAL KUNTAL NARECHANIA 180. 657 VIDHIN VIVEK KOKANE 181 658 HARSH PHOGAT 182 663 SAGAR KUMAR SINGH 183 665 SUYASH DHURAWAT 184 669 RAJAT CHAWLA 185 682 DEVAK SANTOSH 186 684 NYNAN NOUSHAD 187 686 PRASHOB CHANDRAN, 188 693, AKANKSHASAHU: | 189 695 REETHU REDDY 190 708 KIRANJEET KAUR SAINI | 191 715 GANDHI AADIL MOHAMMAD SHAFI | 192 722 NISHANT RANA 193 723 STANLEY NGANGBAM. 194 728 AKSHATA RAJENDRA DUMRE 195 735 RAJDEEP DAS 196 742 RISHIKA PALI | 197 744 POOJA SARAP, dl 198 750 _DHANANJAY BHOGLE 199 756 SUDANSH DAJI KHANDARE 200 758 MOHAMMED ARFIN ASHRAF 201 760 NAJIULLAH KHAN 202 764 IMAIL BIN RASHID 203. 785, KRITIKA BAHL Orikac —~ealle O8 Ue 202 Page 5 of 14204 788 ROSHAN PREMSINGH GORKHA 205 789 RISHI GANGAL Fal 206 791 PATEL PRINCEKUMAR H. a 207 793 VISHNU. S 208 805 HARSHDEEP SINGH 209 808 SHUBHAM RUPESH KAMBLE 20 810 | MEHAKJAIN 211 812 AJAY PAL KAUSHAL 22 819 MOHAMMAD BILAL 213 825 AYAN KHAN, 214 829 PRAWIN NAGARAJ 215 B46 AYUSH SINGH 216 848. PULKIT CHADHA. 217, 855 | TARUNGUPTA 218 863 SHRADHA DABRAL 219 864 VAIBHAV GAJBIYE. 220 869 PRAFFUL ITAPE 21 886 | TEJASHREE PANCHAT, 22 891 NILABH KUMAR. 2233 894 AARGHADEEP SAHA 2 895 | JAPMANSINGH ARNEJA_ 2 898 ABHISHEK KUMAR 226 911 PRATHAVI PATEL. 27 922 | SUMANTGAUTAM By 228 928 KUNAL ANTIL ie wey 229 935 | SHUBHAM DAHIVA B30 942 ANUJA SHARAD PAWAR af 953. VARUN SINGH 22 958 SHIVANI BASOL 233 969 ROHIT DEVRANI 234 975 SUBHAJIT DEBNATH_ 235, 985, SHREYA KAPOOR. 26 988. AMAN SHARMA. } 237 997 APPORV GUPTA. 28 1004 | SAHIBDEEP SINGH 239 1007 NAVNEET KUMAR 240 1009 GAURAV BATRA. 241 1016 GEETIKA MAKHJJA_ 242 1038 | SHUBHIAM SHRIKANT PATIL. 243, 1039 | KALYANI GAIKWAD. 244 1042 SHREEYA PAWAR, 245 1048 GAYATRI KAILAS WAGH 246 1084 SARTHAK JOSHI E 247, 1085 KAPIL RAJPUT. 248. 1088 REETRAJ Oxkerc (Ve Page 6 of 18 O8-M 20K)249) 1089 VEERA VIGHNESH ELANGOUAN ] 250 1090 SANYAMIT ARYA. | 21 1101 | JASPREET CHAWLA ] 252 1102 | SPARSH GAUR 253 1117__| NEERAJ PAWAR 254 1121 SIDDHI PONKSHE 255. 1124 | TANMAY VIBHANDIK 256 1135 | AMAN GROVER = 257 1148 | KANISHK BHADUR 258) 1149 | RIPUDAMAN THAKUR 259 1152 | SARGUNSINGH CHHABRA 260 1158 | GURJOF KAUR 261 1165 | SOMIL BISWAS 262 1175__ | SBINAY [363 1181 VISHAL SIROHI L264 1184 ABHIRAJSINGH 265 1185 | TARUN YADAV a 266 1214___| RAJKUMAR SINGH 267 1286 | PATIL ONKAR SIDDHARAJ 268) 1292 | MAHMOOD ZAMON SADEQUIAN 269 1293 | VAIBHAVI BHAURAO GHUGE. 270 1313 | ANDREW NIRMAL 271 1336 | TANUSHRISINGH 272 1346 | PRANJAL YADAV 273 1349 | ABHINAV SANKHLA_ 274 1352 | PALLAVI MAHATO 275 1362 | HARSHITA SHARMA 276 1377 | ADITYA AVINASH PATIL 277 1388 | VIKRANT PRATAP 278 1394 [| AMAN SACHDEV 279 1404 ‘AAKANSH TIPLE 280 1407 [RIA KANSAL. 281 1419 | KAUSTUBH MADHAV PATKI 282 1436 | JOSHIKA 283 1464 | SUYASH VERMA 284 1466 | SUNPREET SINGH 285 1471 | SATYAMSHUKLA 286 1482 ALISHA PIPLANT 287, 1492 | RITESH GULERIA 288 1500__| UTKARSH WADHWA_ 289 1512 | MOHAMMED SAYEED 290 1518 | NIHAL SWAMI 291 1526 | ANSHIKA GURJAR 202 1527 | NAVANSHJAIN a 293 1533, PULKIT OrnkarciNate C8—/1 <2 O81 Page 7 of 14204 1540 ‘NIKET MURUGAN | 295 1543, MANSI SHRIVASTAVA 296 1548, RUSHABH SATRA 207, 1573___| YESHANK RAI 208) 1574 | AJAYKUMAR BEDGE 299 1575 GANESH PAWAR “3 300. 1570__| NITHIN RAJAPPA. 301 1580. RAHMIN KHAN 302 1585___| AMIT NIRMAL 303. 1593___| KSHITIJ NANAWARE 304 1598 NIKESH KURMI 305. 1599 SHARON ELIZABETH JOSEPH 306 1601 DIWAKAR SINGH e: 307 1610 PRIYAL PARSE 308 1614 KARTIK BUDHWANL 309 1615 | KIRAN MOHAN 310 1618 EDU KRISHNAN 311 1621 AVNISH SETH a 312 1623 INDERMOHAN SINGH 313. 1625, DHRUV MANGUKIA_ 314 1630 JAYATI ARORA 315 1632___ | RAHUL 316 1636 | PRASHANTH M 317, 1648 | SURAJ CHANDAK 318 1650 PRANAV SAWANT. 319 1651___| RISHA KHAN SAMMA. 320) 1652__| VISHAL MANOHAR BOOLCHANDANI 321 1653 KOPPIREDDI ATCHUTA ABHISHEK ss 322 1657 SHRUTI TIWARL 323 1658 SHRADDHA GADEKAR- | 324 1659__ | SMRITHI SHETTY S | 1662 MUSKAN MALWANI 1663 NISHANT KUMAR 1664 | FARHAN 1670 __ | ADHIRAAJ DUHAN 1681___ | SHANE FERNANDES 1686 AKASH JOSHI 1688 ‘SHELDON FERNANDES | NINAD DAVE. FRENY SANURA AKASH KHADTALE RONIT VACHHANL RAWHAN HILAL RATHER PSAISRI BHAVYA PRABHAT SHARMA Gc pale Of -2O0R/ Page 8 of 141740 | SHOURYA SUNIL. GOET. 1748 | ABDUL RAOOF 1749 | MOHIT- 1751 ARUN YADAV, 1753 | VARUNSHARMA 1775 | DANIEL ARUL RAVI 1776 | ADITYA MEHTA 1779 | JAISINGH SIDHU 1780 | KORAH JACOB 1781___| ANKITSATAPATHY 1782 | ADITYA KAMBLE 1784 | KAUSTUBH PATKI 1785 | ABHISHEK ARORA. 1793 | PRACHI DHENDE 1795 | TARA CHAURASIYA 1796 | SAURAV SHAILENDAR 1798 | AYUSH AGARWAL 1799 | SHIVAMSOSA | 1800 | FARHAN MURUDKAR | 1801___| SANDEEP SINGH SAMBYAL 359 1813 | RAHUL CHOUBEY 360 1815___| ANSARTBUSHRA 361 1817___| DEVESH PRATAP YADAV 362 1835 | VRINDA VOHRA 363 1849 | VAIBHAV SINGH 364 1857 | PRANAV BHAGWANANI 365. 1860___| KANIKA LATHER 366 1861 | DEVIKA CHAUDHARY 367 1866 | SAMRUD PAI 368 1867 | MAYUR BAVISKAR 369 1868 | AKHIL KATARIA 370 1870__| SIDDHARTH GUPTA a a PRERANA NAKRANI 372 1874 | SHREYAS YADAWAD 373 1876 | GAURIMANCHANDA | 374 1877 ATUL WASKALE | 375 1882 AYAAN AHMED SIDDIQUI | 376 1884 | ROHIT CHINTA | 37 1888 | SANCHI BHARDWAJ 378 1904 | TANUSHREE KULKARNI 378 1918 | CHRISTEENA JOHNSON _ 2 | 380 1922 | PHILIP ABRAHAM THOMAS | 381 1936 | TRISHAA SINGH 382 1938 | TUSHAR SINGH 383 1944 | NAVNEET KULSHRESHTHA O*ROSC1NaWe ORY BOM Page 9 of 14384 1945 SHAURYA SINGH 2 i 385 | 1947 UDAYAN SHLOKE CHAUDHURI 386 1948 | VINAYRADDIGADDAD 387, 1949 KRUSHNAL DODIYA, = 388 1951 | CHANDAN KUMAR ny 389 1954 SIDDHANT CHOUKSEY 390 | 1956 ASHISH RANJAN, 391 1962 SUMEET SAID 392 1964 | ROHAN GUPTA 393 1968 GOKUL SURESH PILLAI i (394 1976 ARJUN JAMBHALE 395 1981 SARANYA SB a 39 | 1982. TANAJI PISAL 397 1987, APURV ACHARYA 308 1991___| SUKRITIPURT 3. List of successful candidates in the RTR (Aero) ~ Part I only examination held at Mumbai on 1* and 2» November 2021: (S.No. Roll No. ‘Name of candidate 1 | 3009 LOGESHW ARAN B ae 3010 AYESHA SEHRAWAT 3 3018 | VARGHESE MANT 4 3020 PRAVIN PAWAR. i 3021 SANDEEP SENGUPTA 7a i jeter 3025 | KANISH'KUMARS z 3026 | ALOORI VIVEK = 8 3027 | ASWATHI > l 3032 SWAPNIL PRADEEP SAWANT 4. Above successful candidates are requested to follow the instructions, attached as Annexure I, while applying for the RTR licenses. Crk iN : O08 —/- 208] (ONKAR NATH) Assistant Wireless Adviser to. the Govt, of India NOTE: All the successful candidates are instructed to apply for the gpa PORTR QeiFicate cum license immediately after declaration of result (within 3 months from the date of declaration of this result). Page 10 of 14ANNEXURE I A. Instructions for candidates who have been declared successful in RTR (A) - Full examination held at Mumbai during 27" September 2021 to 2" November 2021: 1, Successful candidates are requested to apply for RTR (A) license through SARAL Sanchar portal (littpsi/saralsanchar.gov.in) only. 2. License fee of ¥ 5000/- for 20 years and 2 10000/- for lifetime as the case may be; is to be paid through Non-Tax Receipt Portal (NTRP) (Itttp//bharatkosh.gov.in) as mentioned in table below: License to be ‘Name of the payee ‘Address of the RLO issued from under NTRP RLO, Mumbai 008604 - PAO CCA | Assistant Wireless Adviser, WPC Wing Regional Mumbai Licensing Office, Ministry of Communications, 3! Floor, MINL Telephone Exchange Bldg, Charkop, | Sector-5, Kandivali (W), Mumbai-400067 Tel No.+91 22 2868 3202/ 28672351 Fax No, +91 22 28673214 B. Instructions for candidates who have been declared successful in RTR (A) ~ Part I only examination held at Mumbai on 1* and 24 November 2021; 1 Candidates who have been declared successful in Part I only, are requested to apply for RTR(C) license through SARAL Sanchar portal (ittps//saralsanchar.gov.in) only. 1.1 License fee of 2 5000/- is to be paid through Non-Tax Receipt Portal (NTRP) (http/bharatkosh.gov.in) as mentioned in table below: License tobe | Name of the payee ‘Address of the WPC Wing issued from under NTRP WPC Wing, New | 077188-Controller of | Assistant Wireless Adviser (COP), WPC Wing, Delhi ‘Communication | DOT, 6" Floor, Sanchar Bhawan, 20 Ashok Road, Accounts, PAOHQ__| New Delhi-110001 2 Candidates who have been applied for Part I only and declared successful, for renewal of their Indian RTR(A) Licenses, are requested to send the following documents in hardcopy to the concerned Regional Licensing Offices (RLOs) of WPC Wing from where the initial license was issued: i Filled up Annexure 1-A ii, Copy of existing RTR(A) License iii, Two recent Passport size photographs Page 11 of 14iv. Undertaking as per enclosed format v. License Fee of & 5000/- for 20 years and 2 10000/- for lifetime as the case may be; is to be paid through Non-Tax Receipt Portal (NTRP) (hittpy/bharatkosh.gov.in) only as mentioned in table below. This proof of payment may also be enclosed with application completed in all respect. License to be renewed from ‘Name of the payee under NTRP ‘Address of the WPC/RLO where application to be submitted WPC Wing, New Delhi 077188-Controller of Communication Accounts, PAO HQ Assistant Wireless Adviser (CoP), WPC Wing, | DOT, 6% Floor, Sanchar Bhawan, 20 Ashok Road, New Delhi-110001 RLO, New Delhi 077177-Controller of Communication Accounts, New Delhi Assistant Wireless Adviser, WPC Wing Regional Licensing Office, | Ministry of Communications, Northern | Regional Wireless Monitoring HQRS Campus, (PO) Ghitorni, New Dethi-110030. Tel. No. +91 11 2650 2671/ 1712 FAX. No. +91 11 2650 2860 “RLO, Mumbai 008604 - PAO CCA] Assistant Wireless Adviser, WPC Wing Mumbai Regional Licensing Office, Ministry of Communications, 3 Floor, MTNL Telephone Exchange Bldg, Charkop, Sector-5, Kandivali (W), Mumbai-400 067 Tel No.+91 22 2868 3202/ 28672351 Fax No. +91 22 2867 3214 RLO, Chennai 077153-Controller_ of | Assistant Wireless Adviser, WPC Wing ‘Communication Regional Licensing Office, Accounts, Tamilnadu Ministry of Communications, International Wireless monitoring Station Campus, (PO) | Perungudi, Kandanchavadi, Chennai-600 096. | Tel.No.+ 91 44 2496 2070/ 2496 0172, FAX. No. +91 44 2496 4000 RLO, Kolkata 077155-Controller of | Assistant Wireless Adviser, WPC Wing | Communication Accounts, West Bengal. Drawing & Disbursing Officer 201589 DDO cA Regional Licensing Office, | Ministry of Communications, International Wireless Monitoring Station Campus, (PO) Sarkarpool, Gopalpur, Kolkata-700143. Tel. No. +91 33 2401 1431/2401 8801 FAX. No.+ 91.33 2401 4473 Page 12 of 14NOTE: 1. License ix.o. foreign nationals will be issued after getting inter-ministerial clearance. - In case of renewal of RTR(A) license, the same may be renewed from the respective Regional Licensing Office (RLO)/ WPC Wing (HQ) from where the main RTR(A) license was issued. 3. User guide for payment through NIRP is also available at http/oharatkosh gov.in/static/UserGuide.aspx. While making, payment through NTRP, due care must be taken to make payment to Department of Telecommunications (DoT), for the Purpose under RTR (A)/ RTR(Conversion)/ RTR (Permit) License as the case may be. Payment made to any other Department/Ministry will not be taken into consideration. In case of any problem in making payment through NTRP, a “Help Desk” at Room No. 1312, Sanchar Bhawan, New Delhi may be contacted for guidance and support on telephone ((11-23328280, 23036242) and email ID: support. pfms-dot@nic.in. Page 13 of 14UNDERTAKING (Name), s/o Sh... seseusssoseenen(Name), hereby undertake to state that | am not in possession of any RTR Permits issued by WPC Wing, MoC based upon Foreign FRTOL. Hence, I may be issued RTR license based upon the result of RTR (Aero) examination held at (Centre) in ....... (Year) vide my Roll No. OR (Name) holding Indian Permit (RTR(P)) : and sictrendering the same in original in lieu of which I may be issued RTR license based upon the result of RTR (Aero) examination held Ate soeeeseeeesseeene(Centre) in secsssa(Year) vide my Roll No... 2. _If the information given above is found to be incorrect/ false, suitable penal action may bbe initiated against me by the Government of India, Signed at... (Place) on... sess (date) Gignature) In presence of (Witness) Name: Address: Page 14 of 14Annexure I-A FORM OF APPLICATION FOR ISSUE OF CERTIFICATE OF PROFICIENCY IN RADIO TELEPHONE AND LICENCE TO OPERATE 1. (a)Name of Applicant BLOCK LETTERS. (b) In Hindi (if possible.) 2. (a) Name of Examination centre. Paste a recent (b) Month of Exam. Passport 3. Complete postal address Photograph Where licence to be sent. 4 Fathers name. 5. Date of birth. 8. Place of birth. 7. Nationality 8. Height. (a) Mtrs. Cms. 9. Colour of Eyes: 9.Colour of Hair. 10. Complexion. 11. Marks of identification. 12. Type of licence applied for: (a) 20 years. (b) Life Time. (Tick wherever applicable) 13. Details of Bharatkosh receipt enclosed - (a) Amount. (b) Bharatkosh Transaction No. _(c) Date. (For 20 years Licence fee is Rs. 5, 000/- and for Life time Rs: 10, 000/-) DECLARATION 1. _ hereby solemnly declare that the foregoing facts are true and correct and nothing is false therein and nothing material has been concealed there from. 1 also agree that in case any information given by me herein before is found false at later date, the certificate and licence to operate, if granted will be cancelled. 2. | further solemnly give an undertaking that | will not either directly or indirectly divulge to any person, except when lawfully authorized or directed to do so, the purport or any message which I may transmit or receive by means of any wireless apparatus operated by me or which may come to my knowledge in connection with the operation of the said apparatus. 3. I have ‘carefully read and understood the rules contained in the Indian Wireless Telegraphy (Commercial Radio Operators Certificates of Proficiency and licence to operate Wireless Telegraphy) Rules, 1954 and undertake to abide by them. Signature of applicant Name (in Capital Letters). *. |. An identical passport size photograph in an envelope. 2. Copy of Bharatkosh receipt as mentioned above.