Liberia Telecommunications Authority (LTA)

12th Street, Sinkor

Methodist Compound
Monrovia, Liberia
West Africa

LTA-MH-100

ENTITY NAME:
APPLICATION #:
Every piece of Radiocommunications and Telecommunications Equipment used in the Republic of
Liberia must be Type Approved by the Liberia Telecommunications Authority (LTA).
TYPE OF LICENSE REQUIRED (Please Select One)
MF/HF Fixed & Landmobile Stations

Aeronautical Ground to Air Station (Glider, Hang Glider, & Balloon)

Marine MF/HF Fixed & Mobile Stations

Radio License-Aircraft (take-off weight more than 3,200 Kg)

Aeronautical MF/HF Fixed & Mobile Stations

Radio License-Aircraft (take-off weight more than 14,000 Kg)

Aeronautical Ground Station (Airlines)

Radio License for Aircraft (Glider, Hang Glider & Balloon)

Radio License-Aircraft (take-off weight more than 3,200 Kg/less than 14,000Kg)
Other (Please specify)..................................................................................................................................

Purpose of Service......................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
Does the applicant, or any affiliate of the applicant, currently operate MF/HF/Aeronautical Station?
Yes

No

If Yes, identify the Licensee and the date issued?

Licensee......................................................................Date of Issuance.......................................................

For Fixed or Mobile Station indicate the following:Time of Operation (Please Select One)

Day

Night

Day & Night

Number of Base Stations...............................................Number of Mobile Stations...................................................

Traveling Route(s).......................................................................................................................................................
Specify Frequencies to be fitted.
TRANSMIT

RECEIVE

TRANSMIT

RECEIVE

Preferred Frequency Band..........................................................................................................................................

Type of Emission.........................................................Emission Bandwidth..............................................................
EQUIPMENT DETAILS
Type of Transmitter........................................Manufacturer........................................Output Power......................W
Type of Receiver............................................Manufacturer......................................................................................
Type of Antenna.............................................Manufacturer........................................Gain..................................dBi
Antenna Height above Sea Level...........................M
THIS SECTION, FOR AIRCRAFT ONLY
Radio Compass Receiver...............................................Radio Range Receiver........................................................
Marker Beacon Receiver................................................Glide Path Receiver.............................................................

Application Form for MF/HF Radiocommunications License Version one 2007

THIS SECTION, FOR SHIP OR COAST STATION ONLY

Reserved Transmitter.....................................................Output Power...................................................................W
Type of Transmit Antenna..............................................Output Power...................................................................W
Type of Receive Antenna...............................................Output Power...................................................................W
Very High Frequency (VHF) Radio Manufacture......................................................................................................
Name of Licensed Radio Dealer to Maintain Equipment..........................................................................................
Location of Station....................................................................................................................................................
Latitude...............................................Longitude..................................................County..........................................
Name and Qualifications of Operator........................................................................................................................
THIS SECTION, FOR SHIP STATION ONLY [Use of Vessel]
Trade

Fishing

Pleasure

Name of Vessel.......................................................................GRT........................................................................
Port of Registry........................................................................Length....................................................................
Name and Address of Accounting Authority...........................................................................................................
................................................................................................................................................................................
Name of Previous User...........................................................................................................................................
THIS SECTION, FOR AIRCRAFT STATION ONLY
Aircraft Registration Marking......................................................................................................................................
Does the Aircraft have a takeoff weight greater than 20 tones?

Yes

No

Does the Aircraft have more that 38 passenger Seats?

Yes

No

Application Form for MF/HF Radiocommunications License Version one 2007

CERTIFICATION STATEMENT
We declare that we have not commenced provision or operation of any of the telecommunication stations or
networks applied for in this application and every piece of information in this application is true and correct. We
understand that approval from the LTA for this application is based on information declared in this application.
We further acknowledge that, should any of the information declared herein is found to be untrue, inaccurate or
incorrect; any license granted by the LTA will be revoked without notice. The LTA reserves the right to impose
penal sanctions against us under any applicable laws and regulations in force, and this is without prejudice to any
civil remedies that the LTA could bring against us if any of the information declared in the application is found to
be untrue, inaccurate or incorrect.
.

Signature
..

Stamp

Name

Application Form for MF/HF Radiocommunications License Version one 2007

Date

Official Use Only

Date Application Received............................................................LTA

Permission Granted!

YES

MF

HF

Aeronautical Application Number.................................................

NO, Reason(s).............................................................................................................................................................

................................................................................................................................................................................................................................................

Frequency(ies) ..................................................................................................................................................................................................................MHz

Name of Authorized LTA Personnel.................................................................................Title.................................................................................................

Signature .........................................................................................Date Application Processed............................................................................................

License Type............................................................................................................................................................................................................................
Date Issued..........................................................................................Expiration Date.............................................................................................................
Comments:...............................................................................................................................................................................................................................

.................................................................................................................................................................................................................................................

.................................................................................................................................................................................................................................................

Application Form for MF/HF Radiocommunications License Version one 2007