Office of the President of the Philippines

Commission on Information and Communications Technology

NATIONAL TELECOMMUNICATIONS COMMISSION
Regional Office No. VII

Appln. Form No. ntcr7-07

APPLICATION FOR NEW/RENEWAL RADIO OPERATOR CERTIFICATE

( ) NEW ( ) RENEWAL

TYPE AND CLASS OF CERTIFICATE BEING APPLIED FOR:

( ) 1PHN ( ) 1RTG ( ) RLMOP ( ) AIRCRAFT ( ) GROC

( ) 2PHN ( ) 2RTG ( ) SHIP ( ) SROP-FV ( ) AMATEUR
( ) 3PHN ( ) 3RTG ( ) SLP ( ) OTHERS

_______________________________ _____________________________ __________

Family Name First Name M.I.

__________________________________________________________ _______________________
Address Tel. No.

___________ __________________________________ _____ _______ ______ _______

Birth Date Place of Birth Sex Status Height Weight

Place of Exam: _______________________________Date: _______________ Rating: __________

Employer: ______________________________________ Address: _____________________________________

(if previously holder of ROC, please indicate):
Type/Class: ______________ Place of Exam: ____________________ Date: __________ Rating: _____

REQUIREMENTS:
NEW
1. Original copy of report of rating/completion of seminar for RLMOP/SROP.
2. ID picture (2x2-4 copies for RLMOP and 1x1-3 copies for Comm’l SROP.
3. Duly notarized information sheet (handwritten)
4. Certification of employment and Radio Station License for RLMOP/SROP.
5. Birth Certificate/Passport/Voter’s Affidavit /PRC ID/marriage Contract.
6. Long size folder with fastener and self-addressed envelop w/ stamp.
RENEWAL
1. Original copy of ROC to be renewed.
2. a) ID picture (1x1-3 copies for Comm’l/SROP).
b) 3 xerox copies of ROC back to back for RLMOP.
3. Self address envelop with stamp for Comm’l/SROP.

_________________________

Signature
Screened by: ________________ Date: _____________
Approved for acceptance:
___________ Date: __________

Address : Subangdaku, Mandaue City

E-mail: ntcr7@cvis.net.ph
Tel. Nos. 345-0823; 346-0179;Telefax-346-0687