Domain to be transferred:

Type of order:

Transfer/modification

Priority order:

Yes No

Applicant's full name:

Applicant's full name in English (not in case of a private person):

Zip code, city:

Street, house number:

Telephone/fax:

In case of private person identity card number/in case of company tax number:

Email address:

In case of trademark priority registration number:

Administrative contact:

Not the same as applicant

Administrative contact

Name:

Email address:

Full postal address:

Telephone: