Applicant Details
Institution Name
*
Address
*
Applicant is a(n): (Tick as applicable)
*
Individual
Corporation
Unincorporated Association/Partnership
NGO
Nature of Application: (Tick as applicable)
*
New application
Modification an existing license
Renewal of an existing license
Telephone
*
Email
*
example@example.com
Website
*
Name of Representative
*
Title
*
Department
*
Date of Submission
*
-
Month
-
Day
Year
When issued, license Owner will be
*
Address of the Owner
*
State/City/Town
*
Country
*
Registration No
*
TIN
*
Website
*
Email
*
Billing name
*
Name and contacts of person in charge of technical issues.
*
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Documentation
An application letter addressed to the office of the Director General, National Communication Authority, Ministry of Telecom Building, Gumbo, Juba South Sudan.
*
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A technical, operational or business description and justification of what the license is desired for.
*
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A copy of memorandum and articles of association, company/NGO/Association registration certificates, operations license, tax clearance certificate and letter of no objection from Media Authority.
*
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A copy of Nationality certificate for nationals or passport for foreigners in case of an application submitted by an individual.
*
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The completed application form and support documentation must be submitted by hand, post or email to National Communication Authority (NCA) offices; Ministry ofTelecommunications building, Gumbo, Juba, South Sudan.
*
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Declaration and Submission
Name
*
Signature
*
Date
*
-
Month
-
Day
Year
Date
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