TA CMN 3/60-16

Ministry of Meteorology, Energy, Information,

Sanft Building,
Disaster Management, Environment, Climate Change
and Communication.
24861

P.O.Box 1380, Level 2 O.G

Nukualofa, Tonga
Phone: +676 28170Fax: +676
Email: communication@mic.gov.to

Application for a Type Approval of Radio Telecommunications

equipment/device
A. APPLICANT
1. Company Name:
2. Company Address:
3. Name of Contact Person:
4. Contact Tel:
5. Email Address:
B. EQUIPMENT PARTICULAR
1. Equipment Category
a. Public (Cellular) Radio Service Communication (Mobile/Fixed)
a) [GSM / DCS 1800 / Dual Band GSM & DCS 1800 / CDMA /
Satellite-Phone]
b. Short Range Device [e.g. Bluetooth and/or WLAN, remote controls,
RFID, alarm, paging systems and Cordless Phone]
c. Telemetry / Tele-control / Radio Data Service
d. Others (Please Specify):

2. Mobility (Please Select one of the following items)

a. Fixed Station
b. Mobile Station c. Handheld Portable
3. Equipment Type (Please Select one of the following)
a. Transmitter
b. Receiver
c. Transceiver
d. Others (Please Specify): __________________________________________
C. DETAILS OF THE EQUIPMENT
1. Name of the Manufacture:
2. Address of the Manufacture:
3. Brand Name:
4. RF Channel Spacing:
5. Type of Modulation:
6. RF Output Impedence:
7. Software/Firmware Version:
8. Year of Manufacture:
9. RF Output Power:
10.Operating Frequency range (switching range without returning)
Transmit:
Receive:
11.The purpose(s) of this equipment/devices:
P.O Box 1380, Nukualofa,
861
www.mic.gov.to

GOVERNMENT OF THE KINGDOM OF TONGA.

Telephone (676) 28 170

Fax: (676) 24

12.Any Certificate(s) [e.g. Test Report/DOC/Safety] received: Yes/No

If Yes;
Certificate Number
Issuing Authority
i.
ii.
iii.
DOCUMENTATION
1.
2.
3.
4.
5.

Function block diagram of the device/equipment

Operation and installation manual
Photographs of the equipment
Product Brochures including technical specifications
Certification by the manufacturer or the authorized representative of the
manufacture from the country of manufacture/origin
6. Type approval certificate(s) issued by at least one of the international bodies
or national/territories regulatory Authority body

D. DECLARATION OF APPLICANT

[I/We] hereby declare that the information and documents given by [me/us] in this
application form are to the best of [my/our] knowledge true and correct.

Signature of Applicant:

NAME:
POSITION HELD:
COMPANY NAME:
DATE:

P.O Box 1380, Nukualofa,

861
www.mic.gov.to

GOVERNMENT OF THE KINGDOM OF TONGA.

Telephone (676) 28 170

Fax: (676) 24