APPLICATION FORM FOR NEW COMMERCIAL CABLE TELEVISION OPERATOR LICENCE
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1 Telephone: , Fax: , PO Box: 1072, Thimphu APPLICATION FORM FOR NEW COMMERCIAL CABLE TELEVISION OPERATOR LICENCE Reference: Date:. Guideline to complete the application form: 1. Complete all the information as required. If an information is cannot be given because it does not apply to you please complete it as NA. 2. Before initiating the application and project proposal, an applicant is obliged to have conducted necessary feasibility studies including consultations with officials of the Office of Gup and Thromde representatives. 3. The applicant should have also studied the relevant provisions of the Bhutan Information, Communciations and Media Act 2006 and Rules for Operation of Commercial Cable Television The applicant shall obtain and attach/furnish the following documents along with this application: a) Recommendation/approval from Office of Gup or Thromde Representatives, Approval of Dungkhag/Dzongkhag/Thromde as appropriate. b) Copy of Citizenship Identity Card c) Copy of Security clearance certificate or necessary references d) Two passport size photographs e) The map showing area of your proposed operation Applicant Details: 1. Name of the Applicant 2. Citizenship Identity Card Number 3. Village 4. Geog 5. Dzongkhag 6. Correspondence Address 7. Business Address 8. Telephone No. Business: Residence: 9. Mobile Number. 10. Fax Number. Business: Residence: 11. id.
2 Details of the Establishment: 1. Name of the Cable Television (Establishment Name) 2. Who will manage the Cable Television System(if by Manager, attach the CV of the Manager) 3. How many staff do you expect to employ (estimate) 4. Areas of Operation (Place and Location of Cable Service) 5. Expected number of customers 6. Time duration expected for the commencement of service Technical Details: 1. Exact Location of the satellite television receiving equipment(control Room) 2. Type and number of dish to be installed 3. No. of LNBs (with specifications) 4. No. of Modulators (with specifications) 5. No. of Power amplifiers (with specifications) 6. Cable specifications 7. Type of distribution/transmission (tick): i) (cable) or ii) (Wireless) 8. Land for installation of Control room (tick) i) own land ii) others land 9. Briefly describe how you intend to lay out the cables to the end users: attach if more to explain)
3 10. How do you prefer for receiving the channel package? (attach if more to explain) Declaration: I/We declare that i) The details above are correct and factual. ii) iii) iv) I/We shall not operate the equipment/station without a license issued by the Authority. I/We shall downlink and telecast only those TV channels approved by the Authority based on a legitimate agreement signed with the service providers. I/We shall declare the exact number of TV subscribers connected my/our cable system to the Authority annually during the day of filing the application for license renewal. v) I/We shall strictly abide by the provisions of the Rules for the Operation of CATV, Terms and Conditions of the Commercial Cable Television operation and any other notifications and order issued by the Authority. vi) In the interest of the general public, the approved channel shall be switched off at any time if directed by the BICMA. Affix legal stamp Date Signature of Applicant
4 RECOMMENDING AN APPLICATION BY THE OFFICE OF GUP FOR REVIEW AND APPROVAL OF THE PROJECT PROPOSAL BY THE OFFICE OF DUNGKHAG OR DZONGKHAG OR THROMDE AS APPROPRIATE FOR ISSUANCE OF CATV LICENSE BY THE BHUTAN INFOCOMM AND MEDIA AUTHORITY Guidelines: 1. Respective Office of Gups or Thromdes shall review the application/project proposal and recommend the application for establishment of Cable Television Service in their respective jurisdiction(s) for approval of the Dungkhag or Dzongkhag or Thromde whichever appropriate. 2. The Dungkhag or Dzongkhag or Thromde shall review the application/project proposal in consultation with the recommending authorities and accord its approval or rejection. If an application is rejected, the decision shall be conveyed to the applicant in writing providing reasons. 3. The Dungkhag or Dzongkhag or Thromde shall forward the approved project proposal along with the application in original to Bhutan InfoComm and Media Authority for issuance of a CATV license. A copy of the application and project proposal shall be maintained with the respective approving authorities. Applicant Details 1. Name of applicant. Citizen Identity card No. 2. Name of applicant s Spouse... Citizen Identity card No 3. Village of applicant. Village of spouse.. 4. Geog of applicant Geog of spouse. 5. Dzongkhag of applicant.. Dzongkhag of spouse.. 6. Reason for Application: Establishment of Commercial Cable television Service 7. Name of the Establishment. 8. Areas to be covered by the Establishment.
5 Official use by the Office of Gup Guideline: The concerned officials of the Office of Gup/Thromde shall review the application and project proposal to establish CATV service in their respective jurisdiction carefully considering the impact of the proposal in their respective communities and recommend the application for approval or rejection in the format prescribed below. You are free to change terms and words in this format as per your review and recommendations. Geog/Thromde hereby recommends or does not recommend the proposal of... to establish a CATV service for review and further actions of..dungkhag/dzongkhag/thromde in view of the following reasons: 1. Above mentioned applicant (possesses/does not possesses) good moral character and (has/ has no) adverse record in town/community till date. 2. He/she (is/is not) enterprising (This point may be expanded if necessary) 3. He/she (has/does not have) a good standing/support from the town/community (This point may be expanded if necessary) 4. This proposal (will/will not) be beneficial to our community/town (This point may be expanded if necessary) 5. The proposal is (feasible/not feasible) in view of the reasons: (you may list the reasons) 6. Any other remarks/comments: Recommended/ Not Recommended for Approval (Signature) Name: (Of Gup/Thromde representative) Number: (Telephone/Mobile No) Seal of Office
6 To be completed by Dungkhag/Dzongkhag/Thromde Guideline: The Dungkhag/Dzongkhag/Thromde shall review the application and project proposal along with the recommendation of the Office of Gup/Thromde representatives to establish CATV service in their respective jurisdiction carefully considering the impact of the proposal under the respective administration and approve or reject the application in the format prescribed below. You are free to change terms and words in this format as per the content of your review and decisions. The Application to establish the CATV service license by and recommended by was reviewed by this Dungkhag/Dzongkhag/Thromde. Based on a detailed review of the recommendations of the.. and its own independent review of the project proposal, this Dungkhag/Dzongkhag/Thromde Administration hereby approves does not approve the application of for issuance of CATV license by the Bhutan InfoComm and Media Authority. (Signature) Name: (Of Dungpa/Dzongda/Thrompon) Number: (Telephone/Mobile No) Seal of Office
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