Government of Barbados

mist.forms@barbados.gov.bb

Level 3 & 4 Baobab Tower, Warrens, St. Michael, BB

1(246) 535-1284

APPLICATION FOR LICENCE TO KEEP OR USE A SATELLITE TELEVISION RECEIVER ANTENNA

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

Person in Barbados to be contacted in absence of Manager

Name:

Telephone No

Model and Type of Antenna

Diameter

Proposed site of Installation (if different from 3)

Has approval by Town & Country Planning been given?

Yes

Sign Here

First Name

Last Name

Choose how to sign

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.