Free Republic of Liberland

New Ltd. Company Registration Application

A
New Company

Company name:
Business Description:

B
Contact details (add several contact detail sections if applicable)
Name:
Surname:
Date of Birth (day/month/year):
Nationality:
Passport number:
Phone number:
Email:
Street Address:
City:
Zip code:
Country:

This contact person is (tick all that apply, omissions are explicit):

[ ] e-resident of Liberland
[ ] Shareholder. Number of shares:
[ ] Director
[ ] Nominee
[ ] Beneficial owner
[ ] Politically exposed person (PEP)
[ ] On international sanctions list
[ ] Contact person for the application

C
Attachments
Attach a scanned copy of ID documents of all the persons detailed in section B and make sure you
finished the ID verification at https://liberland.org/en/dashboard.
Attach signed Sanctions Declaration Appendix by all persons in section B separately.

Send the filled and signed form to the Registrar of Companies email
company.register@liberland.org with relevant attachments.
D
Signature

Signed By:

Printed name:

Thank you.

Registrar of Companies
Free Republic of Liberland

Send the filled and signed form to the Registrar of Companies email
company.register@liberland.org with relevant attachments.
 Free Republic of Liberland
New Company Registration Application
Appendix: Sanctions Declaration

A
Director / Beneficial Owner / Declarant
Name:
Surname:
Date of Birth (day/month/year):
Nationality:
Passport number:

Company Name:

B
Declaration
The person named in section A is or has been (tick all that apply, omissions are explicit):

[ ] e-resident of Liberland
[ ] Beneficial Owner (in relation to the Liberland registered company in Section A)
[ ] Director (in relation to the Liberland registered company in Section A)
[ ] Politically exposed person (PEP)
[ ] On any international sanctions list
[ ] On any Offshore Leaks Database
[ ] Accused of financial crimes in any country
[ ] Convicted of financial crimes in any country

C
Signature

Signed By:

Printed name:

Thank you.

Registrar of Companies
Free Republic of Liberland

Send the filled and signed form to the Registrar of Companies email
company.register@liberland.org with relevant attachments.