Details of the applicant
Provide the following details for the applicant—
Applicant's full name
Registered number of company
Registered office of company
Applicant's contact address (if different to registered office)
Electronic mail address
Bank Sort Code and Account Number
Provide details of the name and position in the applicant of three persons, each of whom has authority to bind the applicant for all purposes relating to the award process. Also provide a specimen signature of each of these persons.
Directors or members
Provide the name and job title of each of the directors or members of the managing body of the applicant.
Provide the names of the applicant's associates (as defined in the Wireless Telegraphy (Licence Award) Regulations 2007 (“the Regulations”)) and for each provide details of their material interest (as defined in the Regulations) in the applicant.
Provide the names of all other members of the bidder group (as defined in the Regulations) in respect of which the applicant has completed a document in the form set out in Schedule 3 to the Regulations in accordance with regulation 4(3)(a)(iii) of the Regulations.
Qualification to bid
In relation to the determination by the Office of Communications (“OFCOM”) under regulation 7 of the Regulations concerning whether or not to qualify the applicant to bid in the award process—
(a) provide details of any reason why the grant of a licence to the applicant may be prejudicial to the interests of national security;
(b) provide details of any reason why the applicant may not be a fit and proper person to hold a licence;
(c) state whether any member of the applicant's bidder group has colluded, or attempted to collude, or is colluding or attempting to collude, with another person to distort the outcome of the award process and provide a description of any such collusion;
(d) state whether any member of the applicant's bidder group has acted or is acting in a way which is likely to distort the outcome of the award process and provide a description of any such actions;
(e) state whether any member of the applicant's bidder group, or any person to whom confidential information has been disclosed, has disclosed confidential information, whether directly or indirectly, to any person, and provide a description of the circumstances of any disclosure and the information disclosed, except where the disclosure—
(i) was to a member of the applicant's bidder group; or
(ii) was to OFCOM;
(f) state whether any member of the applicant's bidder group has obtained or is obtaining or attempting to obtain confidential information relating to another applicant and provide a description of any such circumstances;
(g) state whether any member of the applicant's bidder group is receiving or is attempting to receive services in relation to the award process from any person who has provided or is providing services to OFCOM in relation to the award process and provide a description of the services concerned; and
(h) state whether (and provide a description of any circumstances in which) any person who is a member or a director or employee of a member of the applicant's bidder group and also a director or employee of a member of another bidder group is—
(i) taking part in the preparation of both bidder groups for participation in the award process; or
(ii) receiving confidential information relating to both bidder groups.
Provide a brief description of the substance of—
(a) agreements (if any) relating to the management of the applicant; and
(b) any criminal investigations or proceedings in the United Kingdom or overseas of which the applicant is aware relating to the applicant or any member of its bidder group or its directors or officers.
Specified date: 8 March 2007: see reg 1(1).