Customs Form - Customs

Customs Clearance Form

National Telecommunications Regulatory Commission

Richmond Hill, Kingstown, St. Vincent and the Grenadines

FILE NO: CT/01

License for permission to clear Radio Communications Equipment under Telecommunications Act 2001.

First Name:

Last Name:

Email Address:

Phone Number:

Address:

City:

Postal/Zip Code:

Country of Origin:

Type:

Make:

Model:

Serial Number:

TX Power O/P:

Frequency Range:

Number of Units:

Purpose of Use:

Signature: