The Laws of Zambia FOURTH SCHEDULE (Regulation 6 (1)) MIBS/BLC 3 Ministry of Information and Broadcasting Services APPLICATION FOR CONSTRUCTION PERMIT FOR RADIO AND TV BROADCASTING STATIONS IN ZAMBIA SECTIONS I - GENERAL INFORMATION 1. Name/s of applicant/s ................................................................................................................................................. 1.2 Mailing address of applicant ....................................................................................................................................... 1.3 Telephone No ......................................... Telex ................................... Facsimile ...................................................... 1.4 Is fee submitted with this form? Yes No If yes, state amount enclosed K....................................................................................and enclose copy of receipt. 1.5 This application is for (check appropriate boxes) Amateur AM Commercial Public TV Other (Specify).................................................................................................................................................................. SECTIONS II - LEGAL QUALIFICATIONS 2.1 Application is (check one box) Natural person Legal person (corporation) Other 2.2 Nationality of applicant if applicant is a natural person .................................................................................................... 2.3 If applicant is a corporation, identify the date and place where applicant is registered. Date .............................. Place .................................................................................................................................... Attach to this application as Exhibit No. 1 a verified copy of the applicant's registration certification. 2.4 Name, address and citizenship (nationality) of director and each officer of the corporation. 2.5 .......................................................................................................................................................................................... .......................................................................................................................................................................................... .......................................................................................................................................................................................... .......................................................................................................................................................................................... Name, address and nationality of each person who owns stock/share in the corporation. Specify the number Copyright Ministry of Legal Affairs, Government of the Republic of Zambia