Application Form
for applying for delegation of an Internet domain under .hu public domains
(Columns to be filled in on a mandatory basis are in bold letters)

The English translation of the Domain Registration Rules and Procedures and the Application Form is for reference ONLY and by signing this form the Domain Applicant acknowledges that in case of any dispute the Hungarian official versions of the documents are the legally binding ones.
 
Domain name(s) chosen by the Applicant:
(A list of names can be attached on a signed separate sheet).
[  ] New application?		[  ] Amendment?	Reason: _________________
Under which public domain do you ask for the delegation?
[  ] .hu domain			[  ] second level public domain: _________________

Identification data of Domain Applicant (tax number of the legal entity or for the lack thereof the registration/company number; number of the personal identification document (ID card, passport, driving license or residence permit with expiration date) of the natural person, or their birthday or their mother’s maiden name): ____________________

Name of the Domain Applicant as per the personal identification document or per the resolution on the registration (in Hungarian):

Postal address of Domain Applicant:
e-mail address: ____________________	telephone number: ____________________

factor e-mail address: ____________________	factor tel. number: ____________________
 
Administrative contact designated by the Domain Applicant (if other than Domain Applicant)
name: ____________________
postal address: ____________________
telephone number: ____________________	e-mail address: ____________________
 
I declare that

•	I am the Domain Applicant for this domain request or am authorized to act on behalf of the Applicant. I warrant that the data provided in my domain application are accurate, and I acknowledge that if the provided data are not truthful or if I fail to report any changes to the data, it may result in the revocation of the domain.
•	I understand that special attention must be paid to maintaining control over the factor data
•	I acknowledge and accept the provisions of the Domain Registration Policy and consider them binding for the entire duration of the domain application and registration.
•	By maintaining the registration, I submit to the decisions of the Alternative Dispute Resolution Forum.
•	I have read and understood the contents of the Data Privacy Notice and I grant my consent to the processing of my personal data in the records, as well as I accept that the granting of this consent is lawful according to the national law applicable to me.
•	I have read the Application Form in its entirety and approvingly signed, respectively accepted it.

Date: ____________________
Name of Domain Applicant (or name of its representative):
Due signature 
 
Name of the Registrar taking over the application, date of receipt and the signature of the Registrar: