Consultation response form
Please complete this form in full and return via email to reuben.braddock@ofcom.org.uk or by post to:
Reuben Braddock
Ofcom
Riverside House
2A Southwark Bridge Road
London SE1 9HA

Consultation title	Annual Licence Fees for 900 MHz and 1800 MHz frequency bands	
Full name		
Contact phone number		
Representing (delete as appropriate)	Self / Organisation	
Organisation name		
Email address		

Confidentiality
We ask for your contact details along with your response so that we can engage with you on this consultation. For further information about how Ofcom handles your personal information and your corresponding rights, see Ofcom’s General Privacy Statement.
Your details: We will keep your contact number and email address confidential. Is there anything else you want to keep confidential? Delete as appropriate.	Nothing / Your name / Organisation name / Whole response / Part of the response (you will need to indicate which question responses are confidential)	
Your response: Please indicate how much of your response you want to keep confidential. Delete as appropriate.	None / Whole response / Part of the response (you will need to indicate below which question responses are confidential)	
For confidential responses, can Ofcom publish a reference to the contents of your response? 	Yes / No	

Your response
Question	Your response	
What is your response to this consultation?	Confidential? – Y / N

	

Please complete this form in full and return via email to reuben.braddock@ofcom.org.uk or by post to:
Reuben Braddock
Ofcom
Riverside House
2A Southwark Bridge Road
London SE1 9HA