RFIC Form

Radio Frequency Interferance Complaint(RFIC) Form

1. Instrutions to the Licensees

• This interference complaint form is to be used by the Licensees(individuals/companies/organizations)

under Section 22 of the Sri lanka Telecommunications Act No. 25 of 1991 as amended experiencing the
radio interference from external sources.

• Before submitting the complaint, the licensee should ensure that their radio commination system is
operating in accordance with the license conditions and the equipment being used is not faulty. The
interference should also be external to the licensee radio commination system.

• The licensee should provide the detailed information on the interference.

• Complete all appropriate fields and send/email the duly filled form to the following addresse-mail ID.

Director/Spectrum Management
Spectrum Management Division
Telecommunications Regulatory Commission of Sri Lanka
276. Elvitigala Mawatha
Colombo 08.

Fax: 011 2689675 E-mail:rfi@trc.gov.lk

2. Details of the Licensee

Name of the Licensee

Address
Business Registration Number(if any)

Telephone Fax E-mail

3. Details of Authorized Representative of the Licensee

Name of the Authorized Representative

National Identity Card (NIC) Number

Mobile E-mail

4. Details of the Frequency License

Frequency License File Number

Frequency License Number
Date of Expiry

1
5. Particulars of Complaint

Date when the Interference First Noticed

Nature of Interference
If Intermittent: Monday Tuesday Wednesday
Continuous Intermittent
Thursday Friday Saturday Sunday

Interference Duration(Time Period)

Location of Affected Site Coordinates Longitude: Latitude:

Atmospheric Conditions Dry Warm Rainy Humid Windy

6. Details of Affected Radio communications Service

Frequency of Affected Equipment Tx Rx

Type of Service on which interference is being Experienced

Sound Broadcasting TV Broadcasting Private Mobile Public Mobile WLL

Fixed Point to Point Fixed Wireless Satellite Aeronautical Maritime

Others(please specify) ……………………………….

Tx. Output Power Affected Bandwidth Type of Modulation
Antenna Height Polarisation Receiver Sensitivity( μV, dBμV, dBμV/m, or dBm)
Squelch Setting(if applicable) Tone frequency(if used) Designation of Emission

7. Interference Details
Voice Data Video Buzzing Music
Type of Interference Signal
Carrier Noise Other(Please specify) -----------------------------

Parameters of Interference Signal Frequency Field Strength Bandwidth

(if known) Modulation Designation of Emission
Bearing of Interference Omni Directional Variable
Nature of Service Degradation Blackout Noise BER degrade

Increasing daily Decreasing weekend

Growth of Interference
No specific pattern

Interference History of Same Signal(if

any)

Any Additional Information

(Please Attached Monitoring Data if Available)

Signature of Licensee/Authorised Representative Date