In accordance with point 3.6.1. of the Domain Registration Policy
Declaration

for the conversion of domain name(s) from a document-based to a two-factor validation-based registration - Domain User: natural person or private entrepreneur

I, as undersigned: .....................................................
Address: .....................................................
ID: .....................................................

I am requesting the conversion of the following domain(s) I am using from a document-based to a two-factor validation registration.

Domain name(s): .....................................................

Factor data for the confirmation procedure:

E-mail address: .....................................................

Phone number: .....................................................

I acknowledge the risks associated with the Confirmation Procedure based domain registration, including that the person who holds the factors I have provided may have unrestricted access to the domain, even without my knowledge. I understand that I need to pay special attention to preserving the provision over factor data.

Dated: .....................................................

	.............................................
	Signature of Declarant

(If the declarant certifies the document using the AVDH procedure, there is no need for witnesses or for the document to be signed by hand.)

Signed in the witness of:

Witness 1.	Witness 2.
Name:	Name:
Address:	Address:

Signature:	Signature: