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RTR020120221202911 2

1. Adrich Praveen Coelho has applied for a Radio Telephony License (Aeronautical) with application ID RTR020120221202911. 2. The application includes personal details of Adrich such as name, father's name, date of birth, address, nationality, and contact information. 3. No previous licenses have been held and license fees have been paid through Bharatkosh for a lifetime validity license. Adrich declares the information provided is true and agrees to operate any apparatus licensed in accordance with rules.

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41 views3 pages

RTR020120221202911 2

1. Adrich Praveen Coelho has applied for a Radio Telephony License (Aeronautical) with application ID RTR020120221202911. 2. The application includes personal details of Adrich such as name, father's name, date of birth, address, nationality, and contact information. 3. No previous licenses have been held and license fees have been paid through Bharatkosh for a lifetime validity license. Adrich declares the information provided is true and agrees to operate any apparatus licensed in accordance with rules.

Uploaded by

rich
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FOR RTR(A) License: Radio Telephony License (Aeronautical)

License
Application ID - RTR020120221202911

General Information

1. Authorized Person Details

Authorized Person Name ADRICH PRAVEEN COELHO

Authorized Person Designation

Address H.No-1367/B, Raia Damon West, Salcette Goa

Pincode 403720

District South Goa

State GOA

Landline No

Fax

Mobile No 9763131765

Email [email protected]

2. Personal Details

Name ADRICH PRAVEEN COELHO

Father's Name GEORGE COELHO

Date of Birth 04-10-2001

Place of Birth MARGAO

Height 176 Cms

Color of Eyes DARK BROWN

Color of Hair BLACK

Qualification 10+12

Complexion

Occupation Student

Marks of Identification BIRTH MARK ON LEFT TEMPLE

Nationality Indian

Passport No

Date of passport Issue

Date of passport expiry

1/3
Place where Passport Issued

Father's Home Address

Visa Number

Visa Type

Visa Issued Date

Visa Validity Date

Visa Issued By

Foreign Town GOA

Period of Stay in Inda

Country of Visit GOA

Present Address H.No-1367/B, Raia Damon West, Salcette Goa ,South


Goa ,GOA -403720

Permanent Address H.No-1367/B, Raia Damon West, Salcette Goa ,South


Goa ,GOA -403720

Year of Exam 2022

Month of Exam November

Center of Exam Hyderabad

3. Previous License Details

Previous License No Previous License Issue Previous License Expiry Previous License Issue
Date Date Office

Nil

4. License Fee Payment Details

License Validity: Life time

Payment Mode Bharatkosh Bharatkosh Challan Bharatkosh Challan Pay Amount (in Rs.)
Transaction Ref No No Date

Scanned copy of Payment Transaction Receipt attached

5. Declaration

I hereby solemnly declare and say that foregoing facts are true and correct and nothing is false there in and no material has
been concealed therefrom. 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 given an undertaking that the apparatus described here-in-before will be worked in accordance with the
conditions of the licence and operators holding approval certificate of proficiency shall only be employed to work the said
apparatus

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I have carefully read and understood the rules contained in the Indian Wireless Telegraphy (Commercial Radio Operators
Certificates of Proficiency and license to operate Wireless Telegraphy) Rules, 1954 and undertake to abide by them.

Signature of the applicant

3/3

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