Commonwealth Numbered Regulations

1996 No. 309 RADIOCOMMUNICATIONS DEVICES (COMPLIANCE LABELLING) NOTICE - SCHEDULE 4

                       SCHEDULE 4                  Paragraph 7 (2) (a)

APPLICATION FOR SUPPLIER CODE NUMBER

For Your Information The information pamphlet Radiocommunications Standards:
Compliance and Labelling should be read before completing this application
Return your completed form to: Radiocommunications Standards Team
Spectrum Management Agency
PO Box 78
BELCONNEN ACT 2616
It is an offence under section 302 of the Radiocommunications Act  1992 to
knowingly or recklessly make a false or misleading statement. Penalty :
$10,000. How can I obtain additional information?
Please contact your nearest
Spectrum Management Agency (SMA) office
Incomplete or illegible forms may be returned
to the applicant
The authority to collect the information in this form is provided by paragraph
7 (2) (a) of the Radiocommunications Devices (Compliance Labelling) Notice
made under section 182 of the Radiocommunications  Act 1992 .
The information in this form is required to issue a supplier code number that
will be included in a register and used for the purposes of administering the
standards compliance and labelling scheme and auditing of compliance folders.
Applicant's Details      Types of Radiocommunications Equipment	


Name of company (or partnership, trading trust or individual) Tick the box
that indicates the types of radiocommunications equipment manufactured or
imported:
VHF Aeronautical Radios
HF Citizen Band Radios
UHF Citizen Band Radios Australian Company Number (ACN) or Australian
Registered Body Number (ARBN) (if applicable)
1.7/30/40 MHz Cordless Telephones
121.5/243 MHz Emergency Position Indicating Radio Beacons
406 MHz Satellite Distress Beacons Postal address
Postcode 27 MHz Marine Radios Street address of applicant (if same as postal
address, write 'as above') MF/HF SSB International Maritime Mobile Services
Radio
Postcode VHF International Maritime Mobile Service Radios Contact numbers VHF
or UHF Land Mobile Radios
intended for analogue speech
 Phone (      )
VHF or UHF Land Mobile Radios
intended for data transmission

Fax    (      )
MF/HF SSB Land Mobile Radios

Street address where compliance folder to be retained (if same as postal
address, write 'as above') Paging Transmitters
Postcode
Low Power Devices not specified
above Declaration I declare that the contents of this application are true and
correct. Signature of applicant Position in Company, etc Name (Print) Date