R070 - Application to Register a Radiocommunications Device(S) Operated Under a Spectrum Licence

Application to register or de-register a radiocommunications device(s) under a spectrum licence

Instructions for completion

ACMA form – R070Page 1 of 4December2013

ACMA form – R070Page 1 of 4December2013

• Print clearly. Forms which areillegible, unclear or incomplete details may be returned for clarification.
• Applicants seeking to register transmitters and/or receivers must complete section A and sections B and/or C.
• Applicants seeking to de-register an existing device must complete sections A and D.

Disclosure of personal and other details

Information provided by the applicant in a field of this form that is marked with an asterisk (*) is required, by section 147 of the Radiocommunications Act 1992, to be disclosed to the public by the ACMA in a Register of the Radiocommunications Licences. The ACMA will disclose the contents of the Register by making it available for inspection at any ACMA office, on its website and through the sale of a CD-ROM.

Where to send this form

Completed forms should be sent to:

Radiocommunications Licensing and Assignments Section

Operations and Services Branch

Australian Communications and Media Authority

PO Box 78

Belconnen ACT 2616

Facsimile: (02) 6219 5347

Email:

ACMA form – R070Page 1 of 4December2013

A. Applicant/licensee details

ACMA form – R070Page 1 of 4December2013

Name*

Organisation name*

ACN/ABN *

Postal address

Contact details

An authority from the licensee is required if the applicant is not the licensee.

I apply to the ACMA to have included in the register the details of the device(s) set out on the following page and/or specified in annexures (PLEASE INDICATE) of this application, which it is proposed will be operated under the spectrum licence shown below.

Note:

• A charge in accordance with the Radiocommunications (Charges) Determination 2003 will apply to the registration of a device(s).

Signature of applicantDate

Client number of licensee *

ACMA form – R070Page 1 of 4December2013

ACMA form – R070Page 1 of 4December2013

ACMA form – R070Page 1 of 4December2013

B. Registration of transmitter(s) with certificate

ACMA form – R070Page 1 of 4December2013

Please indicate selection by ticking appropriate boxes (or inserting agreement number)in the table below.

I am accredited under section 263 of the Radiocommunications Act 1992 (‘the Act’) to present certificates to the ACMA for the purposes of section 145(3) of the Act in relation to the registration of radiocommunications transmitters to be operated under spectrum licences. Acting in accordance with the conditions of that accreditation, I CERTIFY THAT operation of the device(s) will satisfy conditions that are required to be satisfied, in relation to the issue of such a certificate(s), under a determination made under section 266A. By ticking a particular box (or inserting an agreement number) on the following page, I am certifying that:

Registration by compliance to the relevant s.145(4) determination

I am satisfied that, where the device(s) are operated in accordance with the information set out in the application, the operation of these device(s) meets the condition contained in subclause 6(a) of the Radiocommunications (Subsection 145(3) Certificates) Determination 2012; or

Registration by adherence to Guard Space

I am satisfied that, where the device(s) are operated in accordance with the information set out in the application, the operation of these device(s) meets the condition contained in subclause 6(b) of the Radiocommunications (Subsection 145(3) Certificates) Determination 2012; or

Registration by Agreement with affected licensee(s)

I am satisfied that, where the device(s) are operated in accordance with the information set out in the application, the operation of these device(s) meets the condition contained in subclause 6(c) of the Radiocommunications (Subsection 145(3) Certificates) Determination 2012; or

Core Condition Agreement (where one exists)

I am satisfied that, for the purpose of the core conditions in the licence(s), all spectrum licensees that may be affected by the operation of the device(s) have entered into a written agreement in the form set out in the licence(s) that the device(s) described may be operated in accordance with the information set out in the application.

ACMA form – R070Page 1 of 4December2013

Note: With respect to the Radiocommunications (subsection 145(3) Certificates) Determination 2012, if an IIC has been issued under:

s.6(a), then please tick the column titled “s.145(4)”

s.6(b), then please tick the column titled “Guard Space”, or provide the corresponding mitigation value if available

s.6(c), then please provide the corresponding Agreement Number(s) under the column titled “Agreement”.

C. Registration of receivers

ACMA form – R070Page 1 of 4December2013

The registration of a receiver(s) does not require certification. However, a receiver will not be afforded protection unless its details are in the Register of Radiocommunications Licences.

Accredited persons and licensees are advised to consider the potential for interference from existing services before deploying a service.

D. De-registration of devices

ACMA form – R070Page 1 of 4December2013

Licensees are requested to de-register transmitters (and receivers) that have ceased operation.Where devices that have changed operating conditions, the devices will need to be de-registered first and then re-registered as a new device.

Acknowledgment

ACMA form – R070Page 1 of 4December2013

I lodge this application and certification knowing that:

1. Section 264 of the Radiocommunications Act 1992 provides that incorrectly issuing certificates is a ground for withdrawing my accreditation; and

2. Division 136 of the Criminal Code Act 1995 provides that it is an offence for a person to make a statement in an application which the person knows:

(a) is false or misleading; or

(b) omits any matter or thing, without which the statement is misleading.

I confirm that the relevant certificates have been correctly issued and that this application does not contain any false or misleading information or omit any information without which the statement is misleading.

Accredited Person’s Client number *

Accredited Person’s insurance provider

Insurance policy numberExpiry date of current insurance cover

Signature of accredited person Date

ACMA form – R070Page 1 of 4December2013