Radio Communication Interference Complaint Form
Before completing this form please ensure that you read the notes and instructions above carefully. As SCRA assesses your radio communication interference complaint based on information submitted on this form, please make every effort to complete all appropriate fields.
Section 1 : COMPLAINANT CONTACT DETAILS
Full Name of the Company/Person who is the licensee:
Licence No:
Licensee No:
Licence Category:
Date of Expiry of the Licence:
Contact person for this Complaint:
Address:
Telephone No:
Mobile No:
Telefax:
E-Mail:
SECTION 2 : DETAILS OF RADIO COMUNICATION INTERFERENCE
Type of radio communication service of which the interference is being experienced (tick appropriate)
a) AM Radio
b) FM radio
c) Cellular Mobile
d) Land Mobile
e) Television Broadcasting
f) Aeronautical
g) Fixed
h) Satellite Fixed
i) Broadband Wireless Access Service
j) Maritime Mobile
k) Others
If you select ‘Others’ above, please provide details
1. Please provide all frequencies and bandwidths on which interference is being experienced:
2. Frequency of interference signal if known or suspected:
3. Station/Site Name (s):
4. Location (s) of station (s) that is/are experiencing theinterference. If available, please provide the geographical coordinates of the location (s) of station (s) in WGS84 format, in terms of degrees, minutes and seconds.
5. Symptoms of interference and nature of degradation of signal (If necessary you may attach further details of you interference complaint on a separate sheet of paper):
6. When did the interference start? Approximate time and Date:
7. Is the interference continuous or intermittent (irregular)?
8. If intermittent please specify when it occurs, how often and for how long does it last?
9. Can the interference be heard on both the transmit(e.g base) and/or receive units? (e.g. mobiles)
10. What sound does the interference signal make on your equipment?(i.e. voices, buzzing, tones etc)
11. If conversations can be overheard, please provide any information on the company, i.e. name or the nature of business in which they are involved?
12. If conversations can be heard - can both sides i.e. the base and the mobile be heard?
13. Has your equipment been checked by your equipment supplier? If Yes - What is the name of the company and when was this done?
14. Is a repeater or fixed base in use? If so provide location of each:
15. Direction of interference if known:
16. Suspected source of interference:
17. Any additional information:
Please attach copies of any interference monitoring data if available (e.g. spectrum analyser plots and audio file of interference).
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