ASOC Application Form
ASOC Application Form
ASOC Application Form
Application from an individual for a licence to Establish, Maintain and Work an Amateur Wireless
Telegraph Station in India. (See rules 6 & 8)
1.Name:( In Capitals)
..
(Last name)
(First)
(Middle)
2. Father's Name :
and Address
3. Address (Present) :
4. Address (Permanent)
:
City/Town
State
Res. No.
Mobile No.
Personal Email
5. Date of Birth
(DD/MM/YYYY)
District
PIN
Place of Birth
Nationality
Occupation
INDIAN
(b) Exact location of the Station
Cert. No.
Date of Issue
Yes / No
Validity
Month of Examination
Yes / No
DECLARATION
I hereby solemnly declare that the foregoing facts are true and correct and nothing is false therein and
nothing material has been concealed there from. I also agree that in case any information given by me
herein before is found false at a later date, the licence, if granted, will be cancelled.
I further solemnly give an undertaking that I will not either directly or indirectly divulge to any person,
except when lawfully authorised or directed to do so, the purport of any message which I may transmit or
receive by means of any wireless apparatus operated by me or which may come to my knowledge in
connection with the operation of said apparatus.
I have carefully read and understood the rules contained in the Indian Wireless Telegraphs (Amateur
Service) Rules, 1978 and undertake to abide by them and observe the conditions of the licence. The
licensed station shall not be made accessible to any unauthorised person at any time.
Signature of witness
Signature of applicant
Address:
Date :
Date :
Place :
APPENDIX III
NATIONALITY CERTIFICATE
Certified that I have known Shri / Smt / Kum ____________________________________
son/daughter of Shri ______________________________
that to the best of my knowledge and belief he/she bears a good moral character. He / She is of
INDIAN nationality. He / She is not related to me.
Address :
Signature:
Dated:
Designation :
Office Seal
(Should not be only in local language)
Note- This certificate should be from one of the officers listed below :1. Gazetted officers of Central or State Governments.
2. Members of Parliament or State Legislatures.
3. Sub-Divisional Magistrate/Officer.
4. Tahsildars or Naib/Deputy Tehsildars Authorised to exercise magisterial powers.
5. Principal / Head Master / Head Mistress of the recognized institutions (School / College) if applicant is a Bonafide student of that
institution.
2. Date of birth
3. Place of birth
4. Age
5. Height
6. Colour of eyes
7. Complexion
8. Colour of hair
9. Identification marks
:
Pin:
11. Occupation
(Major work or profession for
which you receive money)
12. Nationality
13. Fathers name and home address
(Aliases if any)
Indian
:
Pin:
Pin:
Date:
(Signature of applicant)
15. Age
16. Height
18. Complexion
:
Pin:
22. Occupation
(Major work or profession for
which you receive money)
12. Nationality
14. Fathers name and home address
(Aliases if any)
Indian
:
Pin:
Pin:
Date:
(Signature of applicant)
26. Age
27. Height
29. Complexion
:
Pin:
33. Occupation
(Major work or profession for
which you receive money)
12. Nationality
15. Fathers name and home address
(Aliases if any)
Indian
:
Pin:
Pin:
Date:
(Signature of applicant)
37. Age
38. Height
40. Complexion
:
Pin:
44. Occupation
(Major work or profession for
which you receive money)
12. Nationality
16. Fathers name and home address
(Aliases if any)
Indian
:
Pin:
Pin:
Date:
(Signature of applicant)
Government of India
Ministry of Communication & Information Technology
Department of Telecommunication
Wireless Monitoring Organisation
IWMS, Perungudi, Chennai 96
(Two copies of this page are to be submitted)
___________________________________
Date
____________________
To
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
Subject:- Result of Amateur Station Operators Certificate Restricted Grade Exam
held on ____________ at ____________________ Roll No: ______________
Sir/Madam,
I am directed to inform you that:1) You have been declared successful in ______________________ Examination. The papers are being
forwarded to the Assistant Wireless Advisor to the GOI, Amateur Section, WPC Wing, Ministry of
Communication & IT: 616, Sanchar bhavan, 20, Ashoka Road, New Delhi 1100 001. As soon as the
decision to grant the Amateur License is taken by the Ministry, you will be intimated by the Ministry
accordingly. You are requested not to send any money or papers until unless it is asked for.
2) You have not qualified in the ______________________ Examination.
3) Communication regarding grant of license will be sent to you by the Assistant Wireless Advisor to the GOI,
Amateur Section, WPC Wing, Ministry of Communication & IT, New Delhi in due course.
4) You may file your license application on-line on web site www.wpc.dot.gov.in as soon as you received this
letter.
Yours faithfully,
To,
The Assistant Wireless Advisor to the GOI
Amateur Section, WPC Wing,
616, Sanchar Bhavan, 20, Ashoka Road,
New Delhi 110 001
Log on www.wpc.dot.gov.in for Guidelines / Forms / Rules & Regulations and other Amateur activities
Government of India
Ministry of Communication & Information Technology
Department of Telecommunication
Wireless Monitoring Organisation
IWMS, Perungudi, Chennai 96
(Two copies of this page are to be submitted)
___________________________________
Date
____________________
To
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
Subject:- Result of Amateur Station Operators Certificate Restricted Grade Exam
held on ____________ at ____________________ Roll No: ______________
Sir/Madam,
I am directed to inform you that:5) You have been declared successful in ______________________ Examination. The papers are being
forwarded to the Assistant Wireless Advisor to the GOI, Amateur Section, WPC Wing, Ministry of
Communication & IT: 616, Sanchar bhavan, 20, Ashoka Road, New Delhi 1100 001. As soon as the
decision to grant the Amateur License is taken by the Ministry, you will be intimated by the Ministry
accordingly. You are requested not to send any money or papers until unless it is asked for.
6) You have not qualified in the ______________________ Examination.
7) Communication regarding grant of license will be sent to you by the Assistant Wireless Advisor to the GOI,
Amateur Section, WPC Wing, Ministry of Communication & IT, New Delhi in due course.
8) You may file your license application on-line on web site www.wpc.dot.gov.in as soon as you received this
letter.
Yours faithfully,
To,
The Assistant Wireless Advisor to the GOI
Amateur Section, WPC Wing,
616, Sanchar Bhavan, 20, Ashoka Road,
New Delhi 110 001
Log on www.wpc.dot.gov.in for Guidelines / Forms / Rules & Regulations and other Amateur activities
From:
Parent
Guardian
Head
of
Institution
of
Signature
Self verification
Type of
applicants
ALL
Application form
description
Main Application
()
Nationality Proof
Personal Particulars
All Attestations
Age proof
Photos
Properly filled
Nationality
certificate
attached
Attested copy of
all data pages of
my passport
attached
Independent
verification
()
Self verification
Type of
applicants
Application form
description
Self addressed
Envelope
Result sheet
Date column in all
forms
For Minor
applicants
(Age
between
12 - 19
Radio
Theory and
Practice
exemptee
Parental consent
form
Part 1 Exemption
certificate holders
()
Independent
verification
()