Mobile Telephony Operator Registration Form

Mobile Telephony Operator Registration
CUSTOMS DEPARTMENT, MALTA
(Mobile Virtual Network Enabler)

In terms of The Excise Duty Act - Chapter 382

The fields marked with an asterisk (*) are required
Details of Applicant
Name of Applicant:*
VAT Registration Number*
Postal Address of Applicant*
Post Code*
Details of Contact Person
Name and Surname*

First NameLast Name
ID Number*
Occupation*
Telephone Number*
Mobile Number*
Email*
Email*
example@example.com
Application Request

I hereby apply for the supply of mobile telephony services in the Republic of Malta
Date of commencement of operations*

DayMonthYear
Date
Please submit with this application

I hereby apply for the supply of mobile telephony services in the Republic of Malta
Copy of original VAT certificate*

Cancelof
A list of Director(s) and Company Secretary from MFSA (including front and back of their respective ID Cards)*

Cancelof
Copy of Police Conduct of Director(s) and Company Secretary*

Cancelof
Copies of any permits, licenses or certificates relative to the legal status of your trade*

Cancelof
The Customs Department reserves the right to request the original copies of all the above
Please upload declaration form*

Cancelof
The Declaration Form may be downloaded from here
Data Protection
The Customs Department will use the information provided to process this form in accordance with the applicable law. We may check information provided by you, or information about you provided by a third party, with other information held by us. We will not disclose information about you to anyone outside this Department unless permitted by law. The Commissioner for Revenue will treat your personal information in accordance with the General Data Protection Regulation 2016/679 to protect your privacy. Any queries may be addressed to the Data Controller, Customs Department.
Please verify that you are human*
Should be Empty:

Mobile Telephony Operator Registration

CUSTOMS DEPARTMENT, MALTA

Details of Applicant

Details of Contact Person

Application Request

Please submit with this application

The Customs Department reserves the right to request the original copies of all the above

Data Protection