FORM-BTRC: ISP

Bangladesh Telecommunication Regulatory Commission

IEB Bhaban (5th, 6th & 7th Floor), Ramna, Dhaka-1000.

Application Form for Internet Service Provider (ISP) License

( For Data Communication excluding Voice Communication )
[ See Section 36(5) of the Bangladesh Telecommunication Act, 2001 ]
[ Please see the General Information and Guidelines ]

□ NEW □ RENEWAL
[Incomplete application will not be entertained and summarily rejected]
A. Applicant Profile 7

1. Name of Entity:
Registered Office Address

Telephone & Mobile

Fax
E-mail Website

2. Name of Contact Person:

Full Address for
Communication

Telephone & Mobile

Fax
E-mail Website

3. Type of ISP: [ ] Nationwide [ ] Zonal

a. Zone : [ ] Central Zone [ ] North-East [ ] South-East [ ] North-West [ ] South-West
b. Coverage Area : ( Districts Name Only )

B. Service Profile (Applicable for Renewal) 7

1. Location of Installation :

2. Date of Commencement of the Service: _______ / _______ /__________

Day Month Year

3. Application for the period: _______ / _______ /__________ To _______ / _______ /__________
Day Month Year Day Month Year

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 FORM-BTRC: ISP
4. Number & date of License of which renewal is sought for:
License Number
& Date :
5. a. Number of Clients/Users of Internet:
Home: Office : Cyber Café: Others :
b. Number and list of Clients/Users of domestic point to point data connectivity:
Corporate user: Branch User: Personal user :

C. Technical Profile 7
1. Type of Service: [ ] Dial-up [ ] Wireless [ ] Wired (Optical/Copper)
a. Dial-up
Number of telephone lines provided by the PSTN : Access Code :

b. Wireless
Number of BTS / PoPs : Frequency : /
c. Wired
Length of laid cable : Km. □ DSL □ ADSL □ Optical Fiber □ UTP □ STP

2. Bandwidth: [ ] IIG [ ] Sublease

Provider : Allocation : Up - Down -
Medium :

Backup : Allocation : Up - Down -

Medium :
(If medium is authorized VSAT, Please mention frequency) Frequency : Up - Down -

3. Disaster Recovery Center / Data Center :

Address of Installation :

Connectivity Allocation : Up - Down -

Provider : Medium :
(If medium is authorized VSAT, Please mention frequency) Frequency : Up - Down -

D. Pay Order/Bank Draft Details 7

Type of Payment: [ ] P.O. [ ] D.D.

a. Name of Bank :
b. No. : c. Date :

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 FORM-BTRC: ISP
E. Documents to be Enclosed for New ISP License:
[
7
Use tick [√] mark in the appropriate box
Serial Items Attached Not Attached Remarks
1. Application in a Letter Head Pad
2. Relevant Fees in the form of Pay Order/Bank Draft
3. Agreement with the bandwidth provider ( IIG/Sublease)
4. House-Rent Agreement/Ownership deed.
5. Description of existing business
6. Bank Solvency Certificate
7. Documents for financial capability to run the business
8. Undertaking about not as a Bank Defaulter
9. Certificate of Incorporation ( if applicable )
10. Memorandum & Articles of Association ( if applicable )
11. Trade License
12. Network Diagram in details
13. Equipment List
14. Business Plan
15. Proposed Tariff Chart
16. Undertaking on non judicial stamp of Tk. 150/- sworn before
the notary public of Bangladesh about not to take any activity
over VOIP / WiMAX business and not to use any kind of VSAT.
17. Latest Income Tax Clearance Certificate
18. Information with relevant documents regarding the amount of
VAT and Income Tax that the company has deposited to the
Government fund for the last 3 (three) years.
For Renewal of ISP License:
Use tick [√] mark in the appropriate box
Serial Items Attached Not Attached Remarks
1. Application in a Letter Head Pad
2. Relevant Fees in the form of Pay Order/Bank Draft
3. Statement of Payment to the Bandwidth Provider
4. Declaration about not being a Bank Defaulter
5. Trade License ( updated )
6. Expanded Network Diagram in details
7. Equipment List ( for expansion )
8. Internet Clients/Users List (Wireless/Wired)
9. Clients/Users list of Domestic point to point data connectivity.
10. Tariff Chart ( approved by the commission )
11. Certificate from Bangladesh Bank regarding remittance to the
foreign Company. ( if authorized VSAT is Used )
12. Statement of payment for the preceding year made to the
satellite company through the local bank transaction for VSAT
( if applicable )
13. Statement of payment for the Radio Station & Frequency
Charge given to the Spectrum Management Division of the
commission.
14. Total Investment in details.
15. Undertaking on non judicial stamp of Tk. 150/- sworn before
the notary public of Bangladesh about not to take any activity
over VOIP / WiMAX business.
16. Undertaking on non judicial stamp of Tk. 150/- sworn before
the notary public of Bangladesh about not to use VSAT
( if applicable )
17. Latest Income Tax Clearance Certificate
18. Information with relevant documents regarding the amount of
VAT and Income Tax that the company has deposited to the
Government fund for the last 3 (three) years.
19 Bank Solvency Certificate
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 FORM-BTRC: ISP
F. Declaration : 7
1. Has any Application for License of ISP been rejected before? □ Yes □ No
(if yes, please give date of application and reasons for rejection)
2. Has any License issued previously to the Applicant/any Share Holder/Partner been cancelled?
□ Yes □ No (if yes, please give details)
3. Do the Applicant/any Share Holder/Partner hold any other Operator Licenses from the Commission?
□ Yes □ No (if yes, please give details)
4. I/We hereby certify that I/We have carefully read the guidelines/terms and conditions, for the license and I/We
undertake to comply with the terms and conditions therein.
5. I/We hereby certify that I/We have carefully read the section 36 of Bangladesh Telecommunication Act, 2001
and I/We are not disqualified from obtaining the license.
6. I/We understand that if at any time any information furnished for obtaining the license is found incorrect then
the license if granted on the basis of such application shall deemed to be cancelled and shall be liable for action
as per Bangladesh Telecommunication Act, 2001.

Date: Signature
Place: Name of the Applicant/Authorized
Signatory with Seal

Information
ISP Category Information:
Nationwide Central Zone South-East Zone North-East Zone South-West Zone North-West Zone
Anywhere Dhaka City, Brahmanbaria, Sunamganj, Kushtia, Dinajpur,
within the Zinzira & Savar Comilla, Sylhet, Chuadanga, Panchagar,
country Narayanganj District Norshingdi, Habiganj, Meherpur, Thakurgaon,
H/Q Chandpur, Moulvi Bazar, Jhenaidah, Nilphamari,
Gazipur District H/Q Lakshmipur, Sherpur, Magura, Lalmonirhat,
& Tongi Noakhali, Jamalpur, Jessore, Kurigram,
Feni, Netrokona, Narail, Rangpur,
Chittagong, Mymensingh, Khulna, Gaibandha,
Cox’s Bazar, Kishoreganj, Satkhira, Bogra,
Khagrachari, Rangamati Tangail, Bagerhat, Jaipurhat,
& Bandarban Munshiganj, Barisal, Rajshahi ,
Manikganj, Bhola, Natore,
Narayangang excl., Jhalkathi, Naogaon,
District H/Q Pirojpur, Nawabganj,
Gazipur excl. District Barguna, Pabna &
H/Q & Tangi Patuakhali, Sirajganj
Dhaka excl. Dhaka Rajbari,
City, Zinzira & Faridpur,
Savar. Gopalgonj,
Madaripur &
Shariatpur

Note:
• No application for renewal of license shall be entertained beyond 90 days of the expiry of the year of license
concerned and the license shall then stand cancelled and penal action shall follow if the licensee continues his
business thereafter without valid license. The charges/fees/fines upto 90 days if not paid shall be recoverable under
the Public Demands Recovery Act, 1913 (PDR Act 1913).
• The Fees/Charges are given in circular which is given in the website (www.btrc.gov.bd ).
• Application without the submission of complete documents and information will not be accepted.
• For Renewal, please attach a photocopy of the existing license.
• Payment should be made by a Pay order/ Demand Draft in favor of Bangladesh Telecommunication Regulatory
Commission (BTRC).
• The Form fee and Evaluation fee (if applicable) is not refundable.
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