Republic of the Philippines Form No.

NTC 1-12
NATIONAL TELECOMMUNICATIONS COMMISSION Revision No. ____ __01
Revision Date 03/31/2021
BIR Road, East Triangle, Diliman, Quezon City

FORM C (MULTIPLE STATIONS/EQUIPMENT)

APPLICANT MARK KENDRICK R. ASENA

PARTICULARS
Indicate "N/A" for items not applicable.
STATION
EXACT LOCATION MABINI ST., BRGY. POBLACION, MABINI ST., BRGY. POBLACION,
TACURONG CITY, SULTAN KUDARAT TACURONG CITY, SULTAN KUDARAT
LONGITUDE (deg-min-sec) 124.402.646°/124.522425° E. 124°40'39"
LATITUDE (deg-min-sec) 06.41906°/0.6443931° N. 06° 41' 39"
POINTS OF COMM/SERVICE AREA CV CV

ASSIGNED FREQ. 5 GHz BAND 5 GHz BAND

BW & EMISSION 16M50F9 N/A

CONFIGURATION N/A N/A
DATA RATE N/A N/A
CALL SIGN 4FV-735a, 4FV-735b,
4FV-592B, 4FV592B 4FV-735c, 4FV-735d
RSL NO. 2FX-LL-1489 TO 1490-21 4FX-LL-2024 TO 2027-21
VALIDITY (mm/dd/yy) OCTOBER 26, 2023 OCTOBER 26, 2023
OTHERS N/A N/A
EQUIPMENT
MAKE/TYPE/MODEL UBIQUITI AIRFIBER-5XHD MIMOSA C5C
SERIAL NO. EO:63:DA:OF:08:61 / EO:63:DA: 3094991235, 3073063564,
OF:DA:EF 3089688933, 3060215046
POWER OUTPUT 63mW 25 dBm

FREQ. RANGE 5285-5875 MHz 5285-5875 MHz

ANTENNA
TYPE PARABOLIC SOLID TYPE SOLID AIRMAX AC

HEIGHT (M) 80 ft. 80 ft.

GAIN (dBi) 25 dBi 25 dBi

DIRECTIVITY (degrees) D - Directional D - Directional

DIAMETER N/A N/A N/A

POLARIZATION N/A N/A
BEAMWIDTH (degrees) N/A N/A

MARK KENDRICK R. ASENA

Signature over Printed Name of Applicant /
Duly Authorized Signatory/Representative

APRIL 17, 2024

Date Accomplished

THIS FORM IS NOT FOR SALE AND CAN BE REPRODUCED