Suruhanjaya Komunikasi dan Multimedia Malaysia

Malaysian Communications and Multimedia Commission

MCMC Tower 1, Jalan Impact, Cyber 6, 63000 Cyberjaya, Selangor Darul Ehsan

Tel: 03-8688 8000 Fax: 03-8688 1000 http://www.mcmc.gov.my

APPLICATION FOR THE REGISTRATION OF ACCESS AGREEMENTS

UNDER SECTION 90-93 AND 150 OF THE

COMMUNICATIONS AND MULTIMEDIA ACT 1998

1. PARTIES TO THE ACCESS AGREEMENT
Organisation Name
Company No
Address of Registered Office
Postcode
Address of Principle Place of
Business
Postcode
Telephone No / Fax No
Organisation Name
Company No
Address of Registered Office
Postcode
Address of Principle Place of
Business
Postcode
Telephone No / Fax No
Organisation Name
Company No
Address of Registered Office
Postcode
Address of Principle Place of
Business
Postcode
Telephone No / Fax No
Organisation Name
Company No
Address of Registered Office
Postcode
Address of Principle Place of
Business
Postcode
Telephone No / Fax No
2. GENERAL DESCRIPTION OF THE MATTER PERTAINING TO THE ACCESS AGREEMENT
3. DATE OF THE ACCESS AGREEMENT
DD/MM/YY
4. DATE OF EXPIRY OF THE ACCESS AGREEMENT
DD/MM/YY

5. This application is made pursuant to the requirement of section 90 and section 150 (1) of the Communications and Multimedia Act 1998; (please tick)

6. This Access Agreement is for the provision of listed network facilities and network services as per section 150 (1) of the Communications and Multimedia Act 1998; (please tick)

7. The network facilities and services in the Access Agreement are listed in the current Access List made pursuant to section 146 of the Communications and Multimedia Act 1998; (please tick)

8. The Access Agreement is consistent with (please tick):

(i)  The objects of the Communications and Multimedia Act 1998;

(ii)  Any relevant instrument under the Communications and Multimedia Act 1998;

(iii)  Any relevant provisions of the Communications and Multimedia Act 1998 or its subsidiary legislation.

9. Where there is a registered Access Undertaking (please tick):

(i)  The party to the Access Agreement is aware of a registered Access Undertaking lodged by the other party to the Agreement;

(ii)  If the Access Agreement complied with the registered Access Undertaking.


GENERAL DESCRIPTION OF THE ACCESS UNDERTAKING REFERED TO ABOVE (if applicable)
1 / Name and contact details of party whose Undertaking is registered
2 / Date of Registration of the Undertaking
3 / Names and contact details of the parties to whom the undertaking applies
10. DECLARATION
We______
______
______
(names of parties to the Access Agreement) hereby declare that the above information is true to the
best of our knowledge and that we have satisfied the requirements as stipulated in the Guideline on
Registration of Access Agreements under Sections 90-93 and 150 of the Communications and
Multimedia Act 1998.

Signature : Company Stamp :

Name :

Designation : Date :

Signature : Company Stamp :

Name :

Designation : Date :

Signature : Company Stamp :

Name :

Designation : Date :

Signature : Company Stamp :

Name :

Designation : Date :

REQUIREMENTS FOR APPLYING FOR REGISTRATION OF ACCESS AGREEMENT

1.  Parties who wish to apply for registration of an Access Agreement shall abide by the following:

(a)  The agreement shall be submitted in five (5) hard copies in a sealed envelope clearly labeled with the words “Application for Registration of Access Agreements”.

(b)  This Application Form shall be signed by the applicant’s Chief Executive Officer or Chief Operating Officer.

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