Customer D/B/A: Application Date: www.T-MobileTowers.com

T-Mobile Site Number / Name: /

Customer Site Number / Name: /

T-Mobile Towers Initial Application v01.02.09

T-Mobile Towers Initial Application

For consideration, in addition to this completed application, T-Mobile REQUIRES: Specification sheets for antennas (including radiation pattern), mounting bracket(s), coaxial cable, base station equipment, and any other equipment proposed to be placed on the tower. Incomplete or inaccurate application information may cause delays in processing your colocation request.

Please remit application fee to: T-Mobile USA, PO Box 70870, CM9762, St. Paul, MN 55170

*Please remember to insert the T-Mobile Site ID on the memo portion of the check

You may also submit your application via email to

Site Information:

Site Address:

Latitude: ° ' " Longitude: ° ' "

Customer Information:

Legal Entity Name: DBA:

Licensed with the FCC? Yes No - If Yes, FCC License Number:

Mailing Address:

Carrier Development Manager Name: Mobile: Email:

Billing Contact Name: Phone: Fax: Email:

Billing Address (for Rent Payments):

Carrier RF Contact Name: Phone: Fax: Mobile: Email:

Site Acquisition Contact Name: Phone: Fax: Mobile: Email:

Proposed Construction Start Date:

Antenna Information: Proposed Total # of Antennas: Centerline Height: Azimuths: / /

Quantity / Make / Model / Weight / Dimensions
lbs.
lbs.
lbs.

Type of Antenna Mounting Equipment:

Proposed Total Number of Transmission Lines: Mfr. and Type No: Diameter Approx Length: +/-

Proposed Frequencies (Transmit and Receive): Tx: MHz / Rx: MHz Power Output: Watts

Additional Tower Equipment (if applicable): Proposed Total # of Amplifiers (if applicable):

Amplifier Manufacturer and Type-Number(s):

Weight and Dimension of Amplifiers (L x W x D): lbs., " x " x " (each)

Proposed Height and Number of GPS units/Mfg and Type (if applicable):

Proposed Height and Number of Microwave Dishes/Mfg and Type (if applicable):

Ground Equipment Information: Ground Space needed in T-Mobile compound? Yes No - If Yes, dimensions: ' x '

Equipment Manufacturer:

Size of Equipment:

Type of Modulation:

Duplexer/Filter Transmit Bandwidth: @ -3 dB MHz; @ -20 dB MHz

Additional Comments/Requests:

TERMS OF USE: YOU MAY VIEW, COPY OR PRINT PAGES FROM THIS WEBSITE SOLELY FOR THE PURPOSES OF DETERMINING T-MOBILE SITES AVAILABLE FOR CO-LOCATION. YOU MAY NOT OTHERWISE USE, MODIFY, COPY, PRINT, DISPLAY, REPRODUCE, DISTRIBUTE OR PUBLISH ANY INFORMATION FROM THIS WEBSITE WITHOUT THE EXPRESS PERMISSION OF T-MOBILE. YOU MAY NOT USE THE WEBSITE FOR ANY FRAUDULENT OR UNLAWFUL PURPOSE OR SO AS TO DAMAGE OR CAUSE RISK
TO T-MOBILE'S BUSINESS, REPUTATION, FACILITIES OR TO ANY PERSON. ANY VIOLATIONS OF THE ABOVE MAY RESULT IN LEGAL ACTION BY T-MOBILE.
INFORMATION IN THIS WEB SITE IS PROVIDED "AS IS" WITHOUT ANY EXPRESS OR IMPLIED WARRANTIES, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NONINFRINGEMENT. T-MOBILE SHALL NOT BE LIABLE TO ANY PARTY FOR ANY DIRECT, INDIRECT, CONSEQUENTIAL OR OTHER DAMAGES FOR USE OF THIS WEB SITE OR OTHER HYPERLINKED WEB SITES.
AT ANY TIME, T-MOBILE MAY WITHOUT NOTICE MAKE CHANGES TO THIS WEBSITE

T-Mobile Towers Initial Application v01.02.09