Form-No.-NTC-1-04-APPLICATION-FOR-SHIP-SHIP-EARTH-STATION-LICENSE-CARGO-SHIP-SAFETY-RADIO-CERTIFICATE-TEMPORARY-PERMIT-FERRYING PERMIT
Form-No.-NTC-1-04-APPLICATION-FOR-SHIP-SHIP-EARTH-STATION-LICENSE-CARGO-SHIP-SAFETY-RADIO-CERTIFICATE-TEMPORARY-PERMIT-FERRYING PERMIT
Form-No.-NTC-1-04-APPLICATION-FOR-SHIP-SHIP-EARTH-STATION-LICENSE-CARGO-SHIP-SAFETY-RADIO-CERTIFICATE-TEMPORARY-PERMIT-FERRYING PERMIT
NTC 1-04
NATIONAL TELECOMMUNICATIONS COMMISSION Revision No. ____ __01
Revision Date 03/31/2021
BIR Road, East Triangle, Diliman, Quezon City
APPLICANT'S DETAILS
Applicant
Unit/Rm/Bldg No. Street
Barangay City/Municipality
Province Zip Code
Contact Number Email Address
PARTICULARS OF STATION
Name of Ship/Vessel Call Sign
MMSI No. Station License No.
IMO No. Validity (mm/dd/yy)
PARTICULARS OF EQUIPMENT (FOR MULTIPLE STATION/EQUIPMENT, USE FORM A)
Radio Equipment Make Type/Model Serial Number Power Output
Date Accomplished