Apply – Ruyza

First name*

Middle name(s)

Surname*

Surname at birth / previous surnames

Occupation*

Date of birth*

Place of birth* (e.g. Apatin, Serbia)*

Country of birth*

Current nationality*

Nationality at birth (if different)

Sex*

Marital status*

Your email*

Mobile number

Street name and number*

Postal code*

Place of residence (e.g. New York)*

Country*

Proof of identification (max file size 25MB) (e.g. birth certificate, driving license, foreign passport, etc)*

What is your motivation to become an e-Resident?*

Do you have any criminal convictions? If so, please provide information

Do you have any previous e-Resident application rejections? If so, please provide when and why

Any relevant information you would like to provide

I hereby declare that the information provided in this application is true and accurate to the best of my knowledge. I give permission for this application information to be stored in the nations database and I consent to the processing of my personal data for e-Residency purposes and understand that the information may be subject to verification.

I acknowledge that the e-Residency program is subject to the terms and conditions of our country's regulations and may be revoked if I fail to comply with these regulations.

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