Are you completing this form as *

Main Applicant (MA)

Authorized Agent of the MA

Spouse of the MA

Benefactor of the MA

Dependent of MA

Relationship within Application *

Main Applicant

Other relationship

Personal Information

Full Name *

Date of birth *

Gender *

Nationality *

Passport Number : *

Passport Expiry Date : *

Email *

Phone *

Current Residential Address *

Occupation *

Business Information

Company Name *

Business Type

Country of Registration *

Company Registration Number : *

Business Address *

Position in Company *

Digital Identity Verification

Upload Passport Copy *

Upload Recent Photograph *

Your Facebook Link

Your TikTok Link

Your Instagram Link

Your LinkedIn Link

Background Information

Have you ever been convicted of a crime? *

Yes

No

Do you have any ongoing legal proceedings? *

Yes

No

Have you previously applied for or held eResidency in another country? *

Yes

No

Have you ever been involved in any activities related to money laundering, terrorism financing, or other financial crimes? *

Yes

No

Are you currently under investigation by any governmental or regulatory authority? *

Yes

No

Have you ever been denied entry to any country? *

Yes

No

Have you ever been deported or asked to leave any country? *

Yes

No

Have you ever declared bankruptcy or been involved in any insolvency proceedings? *

Yes

No

Do you have any outstanding debts or financial obligations? *

Yes

No

Have you ever been disqualified as a director or had any regulatory sanctions imposed on you? *

Yes

No

Do you hold any political office or are you affiliated with any political organizations? *

Yes

No

Have you ever been involved in any civil litigation cases? *

Yes

No

Have you ever been a member of any organizations that promote violence or discrimination? *

Yes

No

Have you ever been involved in any activities that could be considered a threat to national security? *

Yes

No

Why are you interested in the Kingdom of Kush eResidency? *

Please provide any additional information that might be relevant to your application:

Declaration

I hereby declare that the information provided is true and correct to the best of my knowledge. I agree to adhere to the rules and regulations of the Kingdom of Kush eResidency program.

Your Signature *

Clear

Current Date *

Current Time