APPLICATION

CA/F/MMS/APL-02

FORM
FOR JULY 2018

COMMUNITY
BROADCASTING
LICENCE

Application Form for Community Broadcasting Service Licence 1

 PREPARED BY

SIMON SEAN MSWANIKI

MWANGI EUNICE MUTHONI

1. MANDATORY REQUIREMENTS FOR AN APPLICANT

SECTION A: INSTRUCTIONS

Application Form for Community Broadcasting Service Licence 2

 1. This application should be completed in English and any document in foreign language must be
translated into English.

2. The application should be accompanied by an affidavit sworn by one of the Directors submitting
the documents listed herein in line with the template attached as Annex 1.

3. Completed application form should be presented at our offices on Ground Floor, Wing B, CA
Centre Waiyaki Way, at the Front Desk where you will be issued with a Payment Instruction Form.

4. Payments of fees can be made in by Banker’s or Company Cheque at the Cashier’s office on
ground floor on presentation of the Payment Instruction Form. The Cashier’s office is open in the
morning between 0900 and 1200 hours and in the afternoon from 1400 to 1600 hours on weekdays
(and closed on public holidays).

5. Applicants MUST submit a business plan addressing among others ALL issues highlighted in the
business plan guideline attached as Annex 2.

SECTION B: REQUIRED DOCUMENTATION

I. Originals of the following documents:
1. A covering letter, signed by the applicant, addressed to the Director General (see address below) on Applicant’s
letterhead.

For Kenya Government Entities, the Application letter should be by Institution’s Chief Executive Officer.

2. Original form CR/12 or equivalent from the Registrar of Companies/ relevant ministry listing the directors and
shareholders of the organization/entity and details of their nationality and shareholding – (CR/12 should not be
older than two (2) months from the date of issue) and
(Note: Kenya Government Agencies are exempted from this requirement)
II. Clear photocopies of the following documents of the Applicant:
1. Copy of Certificate of Incorporation/Business Name/Registration Certificates or equivalent and for
other shareholder companies where there is chain ownership in the applicant (Note: Kenya Government
Agencies are exempted from this requirement)
2. Copy of the relevant documents as listed below:
• Cooperative Society’s By-Laws, Membership Agreement Terms and Conditions, Minutes of its AGM
authorizing venture in the service for which the licence is sought; and details of appointed directors or
• Partnership Deed for business name; or
• Constitution of the Society Membership Agreement Terms and Conditions and Minutes of its AGM
authorizing venture into the service for which the licence is sought; and details of appointed directors

3. Kenyan National Identity Cards (ID) or valid Kenyan passports for all Directors and Shareholders of the
Applicant. Both sides of ID should be copied on the same side of an A4 size paper. Copies of passport should
include pages showing the nationality, date of issue and expiry, name and photograph of the holder.

(Note: Kenya Government Agencies are exempted from this requirement)

4. Valid Tax Compliance Certificate/Tax Exemption Certificate for applying entity from Kenya Revenue
Authority.

Application Form for Community Broadcasting Service Licence 3

 SECTION C: APPLICATION AND LICENCE FEE:
The table below shows fees payable for the respective licences:
Broadcast Licence Category Licence Application Initial Licence Annual Operating
Duratio Fee (KShs.) Fee (KShs.) Fee (KShs.)
n (payable when (payable after (payable on/or before
(Years) submitting approval and 1st July of each year)
application before issuance
form) of licence)
10 1,000.00 30,000.00 30,000.00
Community Free-to-Air
Television (on DTT platform)
Community FM Radio 10 1,000.00 15,000.00 15,000.00

Note 1: Frequency fee, in cases where spectrum is utilised, is separately charged in

accordance with the CA Approved frequency fee schedule on an annual basis

Note 2: Applicants for FM radio broadcasting licence MUST complete Application for FM
Frequency Assignment in the Sound Broadcasting Radio Communication Service
form CA/F/FSM/04 for each of the proposed transmission site attached as ANNEX 3

2. APPLICATION ACCEPTANCE SECTION – FOR OFFICIAL USE ONLY

No Application Requirements Receiving Checking

Officer Officer
1. Duly signed Cover letter on applicant’s letterhead
2. Duly completed application form
3. Declaration by the applicant with name, designation, signature and date
4. Duly executed affidavit submitting copies of the documents (no erasures)
5. Business plan for the licence applied for enclosed
6. Application fees paid
Submit all documents using a sworn affidavit while all foreign documents must be notarized.
No Application Requirements Receiving Checking
Officer Officer
Registration Details of Applicant
7. Copy of Certificate of Incorporation/Registration Certificates or equivalent and
similar documents for other shareholder companies where there is chain ownership
in the applicant.
Where the Applicant is a Government Agency/body, a copy of the Act, Gazette
Notice or other relevant legal Instrument creating the Agency.
Ownership Details of Applicant

Application Form for Community Broadcasting Service Licence 4

 8. i) A copy of the document indicating the registered officials of the society
or community based organisation issued by the registering body. ii) For
registered companies,copy of the current CR/12 or equivalent issued within the
last 2 months indicating names of shareholders, their addresses, their
nationalities, shares held by each, names of directors and whether directors
are nominees or not or whether non shareholder directors.
iii)

Identification Documents of owners/Directors (Individuals and Companies)

9. i) Clear Copies of ID for registered officials or directors and shareholders
ii) In case of government officials, submit a gazette notice appointing the
officer.
Other Requirements
10. A copy of the relevant document as listed below to be provided:
Society By-Laws or Constitution (immediately prior to submission of
Application) and Membership Agreement Terms and Conditions for Societies
Partnership Deed for Partnerships
11. Copy of Valid Tax Compliance/Exemption Certificate of the Applying entity from
Kenya Revenue Authority (Not of the owners/Directors)

The Receiving and Checking Officers MUST confirm submission of all requirements by checking against each
requirement before accepting and logging an application
Receiving Officer Checking Officer

Comments: ……………….…………………… Comments: …………….………………….

Name: …………………….…………………… Name: ……………………….…………….

Signature: …………………Date: ……………. Signature: ……………Date: …………….

3. NAME OF APPLYING ENTITY

(In bold capital letters in the order the names appear on Registration Certificate etc)

M/S MWANGI EUNICE MUTHONI............................................................................................

4. APPLYING ENTITY’S CONTACTS

1. Physical Address:
Town NAIROBI Street/Road KIKUYU ROAD

LR No.

Name of Building QUICKMART SUPERMARKET

Application Form for Community Broadcasting Service Licence 5

 2. Postal Address:
P. O. Box Postal Code
………7795……………… ……..00100………..
Post Office Town NAIROBI
3. Phone and Fax Contact:
Tel. No. 0790201831 Fax. No. ………...N/A………

Mobile …….0702834176........ other Tel Nos …….0792548243…….

4.Email Address [email protected] .

5.LICENCE DETAILS

Please identify the community free to air broadcasting service being applied for:
Community Free To Air Television on
5.1. Tick the category of the broadcasting DTT platform
service you wish to provide (tick only
one).
Community FM Radio License

5.2. Provide the name of the area(s) you

wish to provide the broadcasting NAIROBI
service.

5.3. Language(s) of Broadcast service ENGLISH AND KISWAHILI

PROPOSED STATION IDENTITY OF BROADCASTING SERVICE (e.g. Wakenya TV or Wakenya FM) (attach
registration of business name certificate for the station identity)

.................REMI FM....................................................................................

6. OTHER INFORMATION ABOUT THE APPLICANT

6.1 State whether any of the partners/ directors/ shareholders have a beneficial interest in any other business licensed
to provide or operate telecommunication and or broadcasting services.
………NO…………………………………………………………………………………

6.2 Has any previous application by you been rejected under the Act? (If so give details)
…………………………………………………………………………………………
NO
…………………………………………………………………………………………

Application Form for Community Broadcasting Service Licence 6

6.3 Has any previous license granted to you under the Act been cancelled, suspended or modified? (If so give
details)
…………………………………………………………………………………………
NO
…………………………………………………………………………………………

6.4 Have you or any of the directors or shareholders adjudged bankrupt or has entered into a composition or scheme
of arrangement with his creditors or is of unsound mind, if so please explain.
..........................................................................................................................................................................

...........................................................NO...............................................................................................................

IMPORTANT NOTICE: Applicant shall include a separate document containing its business plan that addresses,
among others, all the elements stipulated in the Business Plan Guideline annexed to the form.

7. REFEREES (referees should not be employees of the applicant entity, Ministry of Information &
Communications or the Authority)

The following details should be completed by two different and independent referees who have known you for at
least three (3) years.

1. First Referee I certify that the information given in this form is true and correct to the best of
my knowledge

Full Name SHARLEEN SONIA SAWE

(Block letters as the names appear on the ID/Passport)

Postal Address:
P. O. Box 4564 Postal Code 00100 .

Post Office Town NAIROBI .

Phone and Fax Contact:
Tel. No. …………. 0721679002…………….. Fax. No. …………N/A……………
Mobile ………………………………………………………….Other Tel Nos……….. 0722243690………
Email [email protected] .
OCCUPATION ACCOUNTANT . SIGN sonia sawe

2. Second Referee I certify that the information given in this form is true and correct to the best of
my knowledge

Full Name CHARLOTTE OYELA OKOT

Application Form for Community Broadcasting Service Licence 7

 (Block letters as the names appear on the ID/Passport)

Postal Address:
P. O. Box 5545 Postal Code 00100

Post Office Town NAIROBI

Phone and Fax Contact:
Tel. No. 0785885884 Fax. No. N/A

I/We hereby certify the information we have provided in this application is true and correct to the best of my/ our
knowledge. I/We also understand that it is an offence under the Penal Code to give false information in support of
any application.

Name………………MWANGI EUNICE MUTHONI…………………………………………

Designation………………CHIEF EXUCITIVE OFFICER…………………………………………

(the signatory should be accountable and a senior person in the organisation)
Signature……………………… eunicemwangi ……………………………………………………………

Date…………………9/1/2021………………………………………………………………………

0790201831/0716347973

Email Address:

Director General Communications Authority of Kenya CA Centre, Waiyaki Way P. O. Box 14448,
Nairobi - 00800
Tel: 254-20- 4242000
Fax: 254-20- 4451866.

Application Form for Community Broadcasting Service Licence 8

 10. FOR OFFICIAL USE ONLY

BPC COMMENTS

Not Recommended Recommended

Applicant to do the following: for:

Name:
Designation
Signature:
Date:

Name:
Signature:

Date:

Official Stamp

Deferments:
CLC# Reason for deferment Name & Signature

CLC COMMENTS
The applicant MEETS/ DOES NOT MEET the Authority’s requirements and is hereby
RECOMMENDED/NOT RECOMMENDED for Licensing/Renewal

…………………………………………………………………………………………………
………………………………

Subject To:

Application Form for Community Broadcasting Service Licence 9

…………………………………………………………………………………………………
……………

…………………………………………………………………………………………………
………………………………

The reasons for not recommending the applicant are as follows: -

……………………………………..………………………………………………………………
……………………………
Name:…………………………………………………………...……………………….
Designation………………………………. Signature………………………………
CLC No.…………………………………… Date……………………..………….……

ANNEX 1: TEMPLATE OF AFFIDAVIT TO BE SUBMITTED

REPUBLIC OF KENYA

IN THE MATTER OF OATHS AND STATUTORY DECLARATIONS ACT CHAPTER 15, LAWS OF
KENYA

AND

IN THE MATTER OF AN APPLICATION FOR LICENSE FROM THE COMMUNICATIONS

AUTHORITY OF KENYA

AFFIDAVIT

Application Form for Community Broadcasting Service Licence 10

I, ______NJIHIA JOHNMARK NJOROGE_______________of Post Office Box Number 6098

_NAIROBI_____ (Town)___00100________(Postcode)do hereby make oath and state as follows:

1. THAT I am an adult of sound mind and _________LAWYER__________

(position/ status in the applicant entity) of ____MWANGI EUNICE MUTHONI_____ (name of the applicant) and
hence competent to swear this Affidavit.

2. THAT I am a citizen of the _______REPUBLIC OF KENYA______________ and holder of

National Identity Card No. (or Passport No.) _____39271545________ .

3. THAT ____MWANGI EUNICE MUTHONI________________ (name of the applicant) has resolved to make
an application to the Authority for a ___COMMUNITY FM RADIO LICENSE_____ (name of the licence in
accordance with the Broadcasting Market Structure) licence.

4. THAT I have submitted the following copies of our documents in support of the said application:[tick documents
for which copies have been provided]

4.1. Registration and ownership status:

4.1.1. For an applicant registered under the Companies Act (Cap 486):
4.1.1.1. Copy of Certificate of Incorporation
4.1.1.2. An original letter from the Registrar of Companies listing the directors and shareholders of the
company and details of their shareholding – Original Form CR/12
4.1.1.3. Attach copy of original CR/12 for other companieswhich are shareholder of the Applicantuntil
all shares are attributed to individuals.
4.1.2. Copy of Business Name, or
4.1.3. Copy of Registration Certificate etc.
4.1.4. If the company is listed in a stock exchange in Kenya, copy of Certificate from Capital Markets
Authority (CMA).
4.1.5. For any foreign company which is a shareholder of the Applicant attach copies certified by a
Notary Public of:
4.1.5.1. Certificate of Incorporation of the foreign company/iesand
4.1.5.2. ShareholderRegister of the foreign company/ies.
4.1.6. Copies of Kenyan National Identity Cards (ID) or Kenyan/Foreign passports for all Directors
and Shareholders of the Applicant:
4.1.6.1. Both sides of the ID should be copied onto the same side of an A4 size paper,
and
4.1.6.2. Passport copies should include pages showing the nationality, date of issue and expiry,
name and photograph of holder.
4.2. Compliance with Kenya Revenue Authority rules:
4.2.1. Copy of Valid Tax Compliance Certificate.

4.3. A business plan relevant to the specific broadcasting market segment whose licence is being
sought

4.4. A copy of one of the document listed below:

APPLYING ENTITY REQUISITE CONSTITUTING

DOCUMENT

Application Form for Community Broadcasting Service Licence 11

 1. Non-Governmental Constitution of the NGO
Organization (NGOs)
2. Cooperative Society Cooperative Society’s By-Laws
3. Partnership Partnership Deed
4. Society Society’s Constitution

4.5. Other documents (please list )

............................................................................................................................
5. THAT I swear that the documents listed in 4 above are authentic copies of the original documents issued by the
relevant authorities to the applicant.

6. THAT this Affidavit is sworn in support of _____MWANGI EUNICE MUTHONI___________ (Applicant’s

name) application for _____COMMERCIAL FM RADIO ___________license.

7. THAT what is deponed to herein above is true and within my own knowledge.

SWORN at ___2:00PM_by the said )

)
___ NJIHIA JOHNMARK NJOROGE_________ ) __LAWYER___________
) (Deponent)
This ___17TH_______day of _JANUARY_______ in the year__2021_____ )
)

BEFORE ME )
)
COMMISSIONER FOR OATHS

Drawn by:

____KENDI & COMPANY ADVOCATES ___________________________ (law firm)

_________RIARA CENTRE_____________________(physical address)

P. O. Box ________6478____________

________NAIROBI___________________ (town) ____________00100____________________ (postal code)

ANNEX 2: BUSINESS PLAN GUIDELINE

Please provide separately a Business Plan ensuring that the following details are included in the sequence provided
below. The applicants have to provide separate Business Plans for each license applied for. Any additional
information is encouraged.

1. Executive Summary:
Briefly describe your organization/community detailing the objectives, mode of participation by the community (if
membership based, attach application form, fee details and current list of members) and the business concept,
including summary of services to be provided. Include list of the office bearers, if any and mode of appointment of the

Application Form for Community Broadcasting Service Licence 12

office bearers. Explain the measures that will be put in place to ensure that the service will be operated on a nonprofit
basis and how the service will remain a community asset.

2. Technical Information
Provide the proposed system configuration with block diagrams. Specifically provide details of your studio
equipment, studio to transmitter/BSD link and where satellite is used, the name and transponder being used. Please
indicate if broadcasting equipment quoted complies with the relevant ITU Recommendations for ITU Region 1.

In addition, applicants for FM radio broadcasting licence MUST complete Application for Frequency Assignment
in the Sound Broadcasting Radio Communication Service form CA/F/FSM/04 (Annex 3) for each of the
proposed transmission site

3. Station Programming
Provided your proposed station’s programming indicating the proposed hours of broadcasting for each day of the
week, a schedule of your programme segments for each day of the week, specific value proposition of your
programming format in the proposed coverage area, your own produced programmes and their weekly proportions,
any planned external source of programming (local or foreign). Also indicate if regular news services programmes
on matters of public interest form part of your programming and how often these will be broadcast. Also indicate the
principal sources of news.

4. Market Information
With respect to the proposed coverage area, please provide the rollout plan and a market study report of the area for
which the license is sought detailing the current and future needs of that community, and existing similar
broadcasting services in the area. Highlight any gaps identified in the market and demonstrate how unique your
intended programming is and how you will continue to identify and serve the future needs of its community. Indicate
how you intend to gather information about the needs of the community and what steps, if any, has the applicant
taken to merge, negotiate some type of co-operative arrangement, with any group that represents a similar
community interest in the same licence area.
In addition, explain if and how members of the community will have access to the your decision-making process and
any measures that will be taken to encourage community access and participation in the day-to-day operations of the
proposed service, selection, provision and development of programmes.

5. Revenue Stream
Provide the anticipated revenue stream from sponsorships and other sources describing how in the provision of the
proposed services the business will generate income to sustain its operations and improve the services.

6. Quality of Service Assurance

Describe how you will ensure provision of quality services and how quality services will be maintained in provision
of the licensed services.

ANNEX 3: APPLICATION FOR FREQUENCY ASSIGNMENT IN THE SOUND BROADCASTING RADIO

COMMUNICATION SERVICE CA/F/FSM/04
Serial No...............
1. Administrative Details:

Application Form for Community Broadcasting Service Licence 13

 a) Name of the organisation (or individual) .............EUNICE MWANGI..........................……..
Nationality.KENYAN.......... ID / PP No......39271561........................………………….
Postal address..................67543-00100 NAIROBI...............................……..
Business telephone..........0745742176..............Email.............REMIFM@GMAIL.COM.........................
Physical location: Road/street..........KIAMBU ROAD..... Building..........QUICKMART
............. LR. No........1/765........................
b) Name and postal address of the local supplier (if any)...........................................................................
Postal address......................................................................................................…………………..…..
Business telephone................................................Email.........................................................................
c) Authorised broadcasting area .....................N AIROBI...............................................................
d) Name of person / organisation responsible for payment of bills……………………………………….
…………………………REMIFM HOLDINGS COMPANY……………………………………..

2. Transmitter Site Details:

i) Name...............CRYSTAL....PALACE TRANSMITTING STATION.................................... ii)

LR. No. . . ................... 1/574 ...............................................................................................
iii) Road/Area......................KIAMBU ROAD...................................................................................
iv) Geographical co-ordinates:
Latitude: deg……1…….… min……10…..…. sec………17..…. (N/S)
Longitude: deg…36……….min ……50….…….sec……8…….. (E).
v) Altitude above sea level (in metres)..................................1,600METERS....................
vi) Relative height around 15 kilometre radius……………...1,800METERS...........................

3. Transmitter Equipment Details:

a) Equipment and performance characteristics.

i) Name of Manufacturer.................TRANSSION HOLDINGS.............................................

Make..............................................................CAMON ..........................................
Model.........................................CAMON EOS R5..................................................................
ii) Carrier output power...................33 dBM ...................................................................... iii)
Effective Radiated Power (dB W).......................2.15dBW..............................................
iv) RF bandwidth………………
6DB………………………..kHz v) RF Filter Loss………………
20……………………..…dB

b) Transmit Antenna Details:

i) Type of antenna..................WIRE ANTENNA................... .............................................. ii)

Antenna height above ground level …………120 FEET ………............... ................ iii)
Relative antenna height around a 15 kilometre radius...............130FEET...........................
iv)
Polarization…………………………………….....................................................................
v) Radiation pattern:
a) Omnidirectional: (YES or NO)………………
YES…………………………………….
b) If not omnidirectional provide the following details:
1]Azimuth of the main lobe……………………….…………………………….
2]Angular beam width of the main lobe at the 3 dB point...................................

Application Form for Community Broadcasting Service Licence 14

 vi) Antenna gain in dBi…………………………………… vii) Estimated Antenna losses
(splitter, harnesses, null fill losses) in dB……..............................

a) Feeder:

i) Feeder type……………COAX………………………..
ii) Feeder length………4OOM…………………….……m
iii) Attenuation per metre………2Db /100m....dB iv)
Total feeder loss…………..4……………….….dB

2. Band Pass Filter Details:

i) Name of Manufacturer.........REDRUTH HOLDINGS......................

Make……………HEFA…………………………………………………………………………….
Model................KAMRIN.................................................................................................................

ii) Return loss over the frequency range fc ± 100 KHz………… 456 ……. iii)
Return loss outside the frequency range fc ± 1 MHz…………………24…………
Where fc = Centre Frequency

3. Miscellaneous

i) Proposed date of commencement of service......................1ST FEBRUARY 2021 .............

Applicants Declaration:
I declare that the above information is true to the best of my knowledge

Contact perso…..EUNICE MWANGI….. Designation:…CEO……..…….. Date...17/1/2021.....

Signature:..eunicemwangi.........

Confirmation by your Radio Vendor/Local Supplier:

I confirm that the above information is true to the best of my knowledge

Radio Vendor ……………REDRUTH………… Technical Personnel’s Name………WANDERI KINUTHIA…..

P.O. Box ……2356………………… Technical Personnel’s Licence No.………34B………………………
Date …………17/1/2021……………………………… Signature……………Fgfjdjchcnhghyu…………………..
…...................................
Official Stamp…………………………………

Application Form for Community Broadcasting Service Licence 15