The Laws of Zambia SECOND SCHEDULE (Regulation 3 (4)) FEE PROCESSING FORM 1. Applicant's name ............................................................................................................................................................ 2. Mailing address .............................................................................................................................................................. ........................................................................................................................................................................................ ........................................................................................................................................................................................ 3. Town .............................................................................................................................................................................. 4. State/Country (If foreign Address) ........................................................................................................................................................ 5. Broadcasting Station ...................................................................................................................................................... 6. Call Sign .......................................................................................................................................................................... 7. Type of Fee(s) ................................................................................................................................................................ ........................................................................................................................................................................................ ........................................................................................................................................................................................ 8. Total amount due: fee units................. 9. Total amount remitted with this Application: fee units ........................................................................................................................................ 10. Mode of Payment: 11. Form of Payment: By post ...................................................................................................................................... Hand Deliver .............................................................................................................................. Cash .......................................................................................................................................... Cheque ...................................................................................................................................... Telegraphic Money Order .......................................................................................................... Bank Draft .................................................................................................................................. 12. *If sent by Cheque indicate Cheque No .......................................................................................................................... 13. Applicant's Signature .................................................................................................................... Date ...................... Copyright Ministry of Legal Affairs, Government of the Republic of Zambia