APPLICATION FOR INTERNATIONAL SUBMARINE CABLE LICENCE

PART A: APPLICANT INFORMATION

Nationality (if individual)

Applicant is a (n):

Individual

Corporation

Unincorporate Association

Partnership

Phone Number

Name of Manager of entity

Type of Application

New Application

Modify an Existing Licence

Renew a Licence

Approximate number of persons currently or to be employed by the applicant

Full complement of technical staff to be employed

Licence Type

Terminating Cable

Through Cable

Origin of Cable:

Intended routes:

For terminating cable licence only. Points of connection to telecommunications facilities in Barbados. Name and address of facilities to be connected to

Capital costs of cable

Technical capabilities of cable

Cable Information - Cable Type

Coaxial

Fiber

Other

Applicant to supply details of contacts with the Chief Town Planner:

We declare that we have not commenced provision or operation of any of the telecommunication facilities applied for in this application and all the information in this application is true and correct. We understand that approval from the Ministry responsible for Telecommunications in Barbados is based on information as declared in this application. We further acknowledge that, should any of the information declared herein be found to be untrue, inaccurate or incorrect, any licence granted by the Ministry will be rendered null and void. The Ministry reserves its right to impose penal sanctions against us under any applicable laws and regulations in force and this is without prejudice to any civil liberties that the Ministry has against us if any of the information declared in this application be found to be untrue, inaccurate or incorrect

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First Name

Last Name

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Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.