COP-1

GOVERNMENT OF INDIA
MINISTRY OF COMMUNICATIONS & INFORMATION TECHNOLOGY

FORM OF APPLICATION
For
RADIO-
ADMISSION TO EXAMINATION FOR A CERTIFICATE OF PROFICIENCY IN

TELEPHONY RESTRICTED (AERONAUTICAL)

The form when completed should be sent to: (For use by the Office)
Roll No.
The Assistant Wireless Advisor to the
Govt. of India, To be filled in by the applicant
WPC Regional Licensing Office, Name & Postal address of applicant.
(Respective RLO as mentioned in the (Tel. no. & E-Mail address, if any)
examination schedule.)
Ashirbad Prasad Patra
Ministry of Communications, Northern Regional
AT/PO- Chikiti Gada, Ganjam, Odisha
wireless Monitoring HQRS campus, (PO)
Pin- 761010
Ghitorni, New Delhi-30
Mobile no. +91 8339859411
Tel No. +91 11 2650 2671/1712, Fax No. +91 11
Email ID- ashirbadpatra123@gmail.com
2650 2860

(a) Centre* (b) Class of Examination & Part. (Tick whichever applicable)
NEW DELHI RTR (Aero) Full: ✓ Full RTR (Aero) Pt. I:
Note: -Pt. I - Renewal by Test (copy of Indian Licence/ Foreign
Licence and Indian Permit to be submitted along with application.
Original Licence should be produced during examination for
verification)
(c) Month of examination: AUGUST 2024

(d) Details of Bank Draft. @

(i) Name of State Bank of India branch. PAYMENT VIA BHARATKOSH NTRP

(ii) No. and date 1906240018696 19/06/2024 (iii) Amount: - 500/-

(e) State, if appearing in any other class of COP Examination. (Tick appropriate box)
No. ✓ Yes. Specify class if yes: -
______________________________________________________________________________
● *Name of the Centre duly notified.
● @The Bank Draft should be obtained from any branch of the STATE BANK OF INDIA and
drawn in favor of PAO (HQ), DOT, NEW DELHI payable at STATE BANK OF INDIA,
NEW DELHI, Parliament Street, New Delhi. Service Branch (Code 7687). In case of payment
from Delhi, Banker’s cheque from State Bank of India is also acceptable.
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1. Name of Applicant (In Block Letters) NAME SURNAME

Name in Hindi, if possible.
ASHIRBAD PRASAD PATRA

2. Full postal address to which

Communication to be sent KHUADA STREET AT/PO CHIKITI GADA, GANJAM, ODISHA
761010

3. Permanent Home Address KHUADA STREET AT/PO CHIKITI GADA, GANJAM. ODISHA
761010

4. Contact No. and E-Mail address if any 8339859411 E-mail: ashirbadpatra123@gmail.com

5. Description of Applicant:
(a) Height Meters 1.73 Centimeters 173
(b) Colour of eyes BLACK
(c) Colour of hair BLACK
(d) Complexion BROWN
(e) Mark of Identification MOLE ON RIGHT CHEST

6. Date of Birth: (*Please attach attested

copy of your School Leaving Certificate or
Matriculation Certificate) (Applicant should be of 18 years of age)
30/04/1999

7. Place of birth (with District and State) CHIKITI GADA , GANJAM , ODISHA

8. Name of State to which you belong ODISHA

9. (a) Are you a citizen of India by birth and /or domicile BY BIRTH
Note: A certificate to this effect in the form given at page 4 of the application may obtain from
persons duly authorised from time to time by the Central Government.

(b) If not, to which country you belong?

10. Father’s name, address and nationality (if dead, state

Last address)
ANANDA CHANDRA PATRA, AT/PO CHIKITI GADA, KHUADA STREET, GANJAM,
ODISHA 761010

11. Particulars of Certificates of Competency/Proficiency

If any, already held by the applicant:

Class of Certificate No. and date of issue Authority by whom issued

N/A
N/A
N/A
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12. Educational Qualification of the Candidate 10+2

(Please attach proof, a copy duly attested by a Gazetted officer of Central or State Govt.)

DECLARATION

1. I hereby solemnly declare that the foregoing facts are true and correct and nothing is false
therein and nothing material has been concealed there from. I also agree that in case any
information given by me herein before is found false at later date, the certificate and licence to
operate, if granted will be cancelled.

2. I further solemnly give an undertaking that I will not either directly or indirectly divulge to
any person, except when lawfully authorized or directed to do so, the purport or any message which
I may transmit or receive by means of any wireless apparatus operated by me or which may come
to my knowledge in connection with the operation of the said apparatus.

3. I have carefully read and understood the rules contained in the Indian Wireless Telegraphy
(Commercial Radio Operators Certificates of Proficiency and license to operate Wireless
Telegraphy) Rules, 1954 and undertake to abide by them.

Signature of Witness Signature of applicant

Name: HARSH PATEL Name: ASHIRBAD PRASAD PATRA

Address: B144, SHIV DUPLEX AND Date:
BANGLOWS, GOTRI ROAD Place:
VADODARA, GUJARAT, 390021

Date:
Place:
(To be witnessed by any responsible person)

I enclosed the following documents:

(i) Bank Draft for Rs 500/-

(ii) Character and Nationality Certificate
(iii) Domicile Certificate, if any required.
(iv) Proof of Age (Applicant should be above 18 years of age on the date of commencement of
the examination)
(v) Photographs stamps size 3x4 cms – Two Nos. (One should be pasted in the space provided
in the Attendance Sheet, page no.6, and the second one should be enclosed in an envelope
and secured to the application form).
(vi) Enclosed a self-addressed and stamped (Rs.5/- only) envelope of size 23X10 cm.

Signature of applicant

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 *CERTIFICATE OF CHARACTER AND NATIONALITY

Certified that I have known Shri…………………………………………………………

Son of Shri………………………………………………….for the last…………….……..years
………months. He bears a good moral character and is of ……………………………. nationality.
He is not related to me.

Place: Signature

Date: Name (in Capital Letters)

Designation & Address with Stamp

This certificate should be from any one of the following:

1. Gazetted Officer of Central or State Governments.

2. Member of Parliament or State Legislature
3. Sub-Divisional Magistrate/Officer or Tehsildar
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(This page will be posted to the candidate. Therefore, it should be on a separate sheet of
paper)

GOVERNMENT OF INDIA, MINISTRY OF COMMUNICATIONS & INFORMATION

TECHNOLOGY (WPC WING), Regional Licensing Office, NEW DELHI

ADMISSION CERTIFICATE

Shri ASHIRBAD PRASAD PATRA is hereby admitted to the following examination:

Examination Centre Roll No. Date Time

RTR (A) NEW DELHI

1. Candidates must carefully study the following instructions for strict compliance:

i) No candidate will be admitted to the Examination Hall after half an hour from the
commencement of examination.
ii) Candidates should bring their own pen, ink, pencil, erasures and drawing
instruments.
iii) Candidates shall not be allowed the help of any scribe to write answers for them.
iii) No candidate shall be permitted to leave the Examination Hall unless half an hour
has elapsed after the commencement of the paper.
iv) Candidates are not allowed to take mobile phones/electronic gadgets to the
examination hall.

2. If the candidate is found guilty of impersonation or using or attempting to use unfair means
in the Examination Hall, he is liable to criminal prosecution and/or he may be debarred either
permanently or for a specified period from appearing in the examination.

THE CANDIDATES MUST ABIDE BY ANY OTHER INSTRUCTIONS WHICH MAY

BE GIVEN TO THEM BY THE CHIEF EXAMINER OR THE INVIGILATING OFFICER.

For Assistant wireless Adviser

to the Government of India
Candidate to write his postal address:

To
Shri ASHIRBAD PRASAD PATRA
AT/PO- CHIKITI GADA, KHUADA STREET
GANJAM, ODISHA 761010
EMAIL: ashirbadpatra123@gmail.com
Mobile: +91 8339859411

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 (Please use an exclusive/separate sheet for this page
GOVERNMENT OF INDIA
MINISTRY OF COMMUNICATIONS & INFORMATION TECHNOLOGY
(WIRELESS PLANNING & COORDINATION WING)

ATTENDANCE SHEET

(To be filled by the Candidate, preferably typed and should be on a separate sheet of paper)

Class of Exam: Click the respective box. Paste recent FOR OFFICE USE ONLY
Photograph 3X4
Part I only cm here. The Roll No:…………
photograph should
Part I & II ✓ be signed and dated Sl no of Lic. ……….
on the front.
Name of the Centre: NEW DELHI RTR(A) Lic. No……
Date:………………..

1. Name of the Candidate in BLOCK LETTERS - ASHIRBAD PRASAD PATRA

2. Postal address where the license to be posted.
AT/PO- CHIKITI GADA, KHUADA STREET, GANJAM, ODISHA 761010

3. Father’s name. ANANDA CHANDRA PATRA

4. Date of birth. 30/04/1999

5. Place of birth. CHIKITI GADA, ODISHA

6. Nationality. INDIAN

7. Height in mtrs. 1.73 8. Colour of eye. BLACK 9. Colour of hair BLACK

10.Complexion BROWN

11.Mark(s) of identification MOLE ON LEFT CHEST

12. Particulars of Certificate of Proficiency Licence, if any, already held by the applicant.
(a) Class of Licence. (b) No. and date of Licence. (c) Issued by.

Date Subject Signature of the Candidate

1 2 3
Part I

Part II

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 GOVERNMENT OF INDIA
MINISTRY OF COMMUNICATIONS & INFORMATION TECHNOLOGY
(WIRELESS PLANNING & COORDINATION WING)

INSTRUCTIONS TO THE CANDIDATES FOR FILLING IN THE APPLICATION FOR

ADMISSION TO EXAMINATIONS FOR CERTIFICATE OF PROFICIENCY IN
RADIO-TELEPHONE RESTRICTED (AERONAUTICAL)

1. Application duly completed should reach the Assistant Wireless Adviser to Govt. of
India, WPC Regional Licencing Office of the respective region as mentioned in the
schedule of the examination by the prescribed due date. Applications received,
without proper enclosures and after the due date, will summarily be rejected.
Further, NO enquiry or correspondence will be entertained on the matter. Also
applications otherwise not in order in any manner would also be rejected summarily
without entertaining any correspondence in this regard.

2. Every application form should be accompanied by:-

(i) Two identical copies of the recent photographs of the candidate. The photographs
should be of head and shoulders only (full face) and 3 X 4 cms size. They should
be duly signed and dated in ink on the front and one of them enclosed in a small
open envelop. The other should be pasted on the right hand top of the attendance
sheet enclosed. The name and complete address should be written on the back of
the photographs enclosed in the open envelope.
(ii) The nationality and character certificate in the prescribed format from one of the officers
listed below:-
a) Gazetted Officers of Central or State Governments.
b) Member of Parliament or MLA, MLC of State Government
c) Sub-Divisional Magistrate/Officer
d) Tehasildar of Naib/Deputy Tehasildar authorized to exercise magisterial powers.
(iii) Evidence of age (e.g. Attested copy of Matriculation Certificate or School leaving
Certificate).
(iv) Examination fee in the form of SBI Demand Draft.
(v) Domicile Certificate, in case a candidate is an Indian not by birth, issued by competent
authority, either in original or copies duly attested.
(vi) Enclose a self addressed and stamped (Rs.5/- only) envelope of size 23X10 cm.

3. Candidate’s address, at which he desires to receive his admission Certificate, should be

written in the space provided on the blank admission Certificate form.

4. (i) The prescribed fee should be paid only by a crossed BANK DRAFT OF STATE BANK
OF INDIA. The Bank Draft should be obtained from any branch of the STATE BANK OF
INDIA, and drawn in favor of PAO (HQ), DOT, NEW DELHI payable at STATE BANK
OF INDIA, Parliament Street, New Delhi. Service Branch (Code 7687). In case of payment
from Delhi, Banker’s cheque from State Bank of India is also acceptable.
(ii) In no case, Bank Draft drawn on any other banks/Cheques will be accepted. Defaced or
mutilated Bank Drafts will also not be accepted.
(iii) Fees for the different classes of Certificates of Proficiency Examination is Rs. 500/- only.

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5. There is no minimum educational qualification prescribed for appearing fro these
examinations. It should however, be emphasized that the syllabus for these examinations
is such, as would require a sound educational qualification at least up to Matriculation
standard with Mathematics and Physics as subject for a candidate efficiently study them.
Particular attention of intending candidates is, therefore, drawn to the necessity for a good
general education as a perquisite for attempting these examinations. It is also emphasized
that during the examination the proficiency in English language also will be considered.

6. The language of the examination will be English.

7. No claim for a refund of the examination fees will be entertained, nor can it be held in
reserve for any subsequent Certificate of Proficiency Examination.

8. For detailed syllabus and form of Examination, candidates are advised to refer to the
pamphlet, “Indian Wireless Telegraphy (Commercial Radio Operators, Certificate of
proficiency and Licence to Operate wireless Telegraphy) Rules 1954” available at the
prescribed cost from the Controller, Government of India Publication Branch, New Delhi-
110001 or any of its branches or authorised agents.

9. Certificate of Proficiency Examinations is qualifying examination only. These are not

meant for filling up any vacancy or imparting training.

10. Examination conducted at various Centres during one particular session, if any, will be
considered as one and the same examination. Application for the COP examination shall
be considered for one centre only during a particular session.

11. Candidates are not allowed to take mobile phones/electronic gadgets to the examination
hall.

12. Failure to comply with the above instructions will render the applications liable to be
rejected. No representations on rejected applications will be entertained, in any manner
whatsoever.