Application form for Type Approval of Radio Station
Contents
1. iraile Asia 8 ishali The Hashemite Kingdom of Jordan Telecommunications Regulatory Commission Radio Spectrum Management Department KiNG eide oh chy fay Uf U FAIZ APPLICATION FORM FOR Issue Renew Amendment of Type Approval of Radio Station Telecommunications Regulatory Commission TRC Tel 962 6 5862020 Fax 962 6 5863641 42 P O Box 850967 Amman 11185 Jordan Seventh circle third exit to the right from Airport Highway Ibrahim EI Bajori street http www tre gov jo E mail tre tre gov jo spectrum trc gov jo TRC Application Form 30 Please X the appropriate box Company Stamp Section 1 All items in this section must be completed 1 1 Applicant Information Applicant s Name TRC License No if the applicant is a TRC licensee Address Fax No Zip Code Telephone No E mail Address Web Site if any Source of port Country Company Web Site 1 2 Type of Application New Model TRC Approved Model Modified Model I we certify that I represent the applicant in the capacity indicated below and that I have examined the foregoing technical information and that it is true to the best of my knowledge and belief I we declare that all the information in this Application form is true and correct I understand that approval from Telecommunications Regulatory Commission of Jordan for this application is based on information as declared in this application S2. be completed e Only equipment from the declared source of import is allowed to be marketed and sold in Jordan The applicant will be required to re apply for a new type approval if the source of import has changed e A letter or a proof from the declared source of import stating the models supplied to the applicant TRC Application Form 30 Please X the appropriate box Company Stamp Annex 1 Declaration To be completed by all applications _ Please complete the rest of the application before signing this declaration To the best of my knowledge and belief the particulars given in this document are correct and complete I have read the application notes statements and conditions and will supply the necessary information the attached with my application I Name amp Title Position in Company For and on behalf of Name of Company located at Address Do solemnly and sincerely declare that the following telecommunication equipment Manufacturer Model No imported from Company Address Country Contact Person if possible Tel Fax E mail Complies with and and Standards and shall ensure that only radio communications equipment from the above declared source will be marketed and or operated and or sold in Jordan I shall re apply for type approval if the source of the above radio communications is different from the one declared above I further decl
3. to reject any equipment Please X the appropriate box Annex 3 Declaration To be completed by all applications Please complete the rest of the application before signing this declaration I We declare on my our sole responsibility that the concerned product in this application is conformity with the following ig Any possible method should be done to enable the most efficient use of spectrum such as Bandwidth expansion amplitude modulation and single sideband techniques Frequency tolerance of the center frequency used by the concerned product must comply with the ones specified in tablel Maximum spurious emission power level from the concerned product should be within the range specified in table2 Frequency tolerances and levels of unwanted emissions should be at the lowest value which the service permits In case of using Bandwidth expansion techniques power spectral density should be employed in such manner that ensures efficient use of the spectrum Technical parameters of the receiving station should be considered so as to comply with the class of emission concerned Interference caused by a transmitter located at a close distance from the receiver should be minimized using the appropriate performance characteristic amp parameters Signature amp Name for and on behalf of Name of Company Date Please X the appropriate box Commi
4. are that the specimen s if requested by TRC offered for Type Approval test is are representative of the product envisaged Signature amp Name for and on behalf of Name of Company Date Please X the appropriate box Annex 2 Safety Declaration To be completed by all applications I We Declare that I We have the safety test result relating to the radio communication equipment mentioned in this form as identified overleaf I We declare on my our sole responsibility that the radio communication equipment is in conformity with the following safety standard s and or normative document s and and Telecommunications equipment information Manufacturer Model No imported from Company Address Country Name amp Title Position in Company For and on behalf of Name of Company located at Address Signature amp Name for and on behalf of Date Notes L Please submit the application form to the above address together with the following a An application fee where required b All items specified in Section 3 or 4 us Application without the submission of complete documents will not be accepted ee Payment should be made by a crossed cheque cache payable W to Telecommunications Regulatory Commission or TRC The application fee is not refundable 4 TRC reserves the right
5. ems must be submitted i Colour photographs capturing front rear and side views ii Full test report and other test data relevant to the equipment iii Technical documents include a general description of the equipment the features and facilities the equipment supports iv Manufacturer s Declaration of Conformity v User Manual if any vi Safety Declaration Section 4 For submission of a type approved model 4 1 Conditions for Type Approval under Section 4 The model that has already been granted type approval by TRC The model submitted is identical to the TRC type approved model The applicant shall submit any other documents or items deemed necessary by TRC TRC reserves the right to reject the application if the conditions stipulated under 4 1 1 to 4 1 3 are not met For Official Use Only Application Photographs Equipment Manual Accepted Not Accepted Accepted Not Accepted Acceptable Not Acceptable Specification No Applicant s File No Test Report No TRC Type Approval Certificate No Date of Issue Completed By Signature TRC Application Form 30 Please X the appropriate box Company Stamp All applicants submitting a model that has already been granted type approval by TRC must abide to the following conditions e A TRC Declaration form in Annex must be completed e A TRC Safety Declaration form in Annex 2 must be completed e A TRC Emissions Declaration form in Annex 3 must
6. hould this information be incorrect any license granted by TRC will be revoked I We declare that the attached Application is completed by a technically qualified and competent person and all information given in this Application and in the documents attached are true and correct And in accordance with the conditions stated in the Telecommunications Law No 13 1995 I we will not market and sell the equipment until a Type Approval Certificate has been issued to me us I We warrant that each unit of equipment to be marketed under TRC approval will comply with all applicable requirements as stated in the application Name Please print or type Signature amp Date Position Telephone No Address include ZIP Code TRC Application Form 30 Please X the appropriate box Company Stamp Section 2 All items in this section must be completed 2 1 Equipment Information Model No Year of Manufacture 2 2 Equipment Specification Item Specification Specification Frequency Range Type of Emission Rx Modulation Type b Transmitter RF Output Power dBw W Radiated Spurious Emission Frequency Deviation Limiting kHz Spurious amp Image Response Rejection Output Impedance TRC Application Form 30 Please X the appropriate box Company Stamp Section 3 For submission of a new model currently not type approved in Jordan and a modified model 3 1 Submission Requirements The following it
7. tment I the undersigned acknowledge that I will comply with the following commitments upon getting a Temporary Frequency license 1 Importing the equipment during the license validation time otherwise the approval will be cancelled 2 Using the equipment as it is described in the license 3 Using the equipment for the purpose that it is licensed for Not allowing unauthorized persons to use the station Not transferring the ownership of any of the station stations to other party unless getting an official approval issued from TRC 6 Allowing any official team to inspect on the station at any time to check it s technical specifications it s conformity with the license and it s workers 7 Stop using the station in case the authorized entities asked for it 8 Reporting to the Telecommunications Regulatory Commission and other relevant governmental entities in case of losing destroying storing or re exportation of any equipment 9 Providing the Telecommunication Regulotry Commission with the names of the persons who work on the station stations in case of license renewal 10 Providing the Telecommunications Regulatory Commission with a statement includes types serial numbers and numbers of the stations equipment and a written certificate states that the license does not possess any equipment other than the equipment that is mentioned in the license when asking for license renewal 11 Providing the Telecommunications Reg
8. ulatory Commission with a reinforcement letter from the governmentalentity that has the contract with anda photocopy of that contract 12 Providing the Telecommunications Regulatory Commission with a customs certificate includes the number brand type and serial number of the equipment upon entering or exiting them to the country 13 Shouldering any responsibility that results from not complying with any part of this commitment o e Name Signature Title Please X the appropriate box PLEDGE I the undersigned acknowledge that to the best of my ability I have fully read and understood all the terms and conditions in this application form and completed it accurately Applicant s Name Signature Date Application received by Name Signature Date LY D pf BEEKGT f yy D KLDY Nn Lo d Company Stamp Please X the appropriate box
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