All Fields Specified Or Indicated by * Are Mandatory

All fields specified or indicated by * are mandatory

Section 1: Application Details

Application Date*
Entity Name*
Entity Registration Number*

Section 2: Administrative Services

Certified true copy / ☐ Certificate of Incorporation / Registration
☐ Certificate of Incorporation on Change of Name
☐ Commercial License
☐ Articles of Association
Certificates / ☐ Certificate of Incumbency
☐ Certificate of Good Standing
☐ Zero tax certificate
☐ Certificate of status (under formation certificate)
Extract / ☐ Business Extract (information of entity filed with the Registrar)
No Objection Certificate / ☐ Please indicate the purpose. The Registrar may request for documents that supports your request:
Attestation / ☐ Witnessing Signature
☐ Attestation of document as true copy
Please indicate the propose date and time.
Date:
Time:
Kindly ensure that a confirmation is receive from the Registrar prior to visiting ADGM office.

Section 3: Signature

I declare that the information in this application and any attachments is true and complete as at the date of this form.
Signature / Date
Name / Designation

Party lodging this application

Title*
Forenames*
Surname*
Designation*
Organisation
Office Number
Floor
Building Name
Street Name of Cluster / Square / Area on the island
State / Province
Emirate
Country
Telephone*
Email*

Checklist

Please make sure to complete all the required fields in the form and the following supporting document(s) are attached. Incorrect or incomplete applicationmay be returned for re‐submission.
IfanydocumentsarenotintheEnglishLanguage,theymustbeaccompaniedbyatranslation,certifiedtothesatisfaction of the Registrar. Please referto Registration Authority’sRules on translation and authentication.
Please submit the completed document to

Documents Required

No. / Requirement / Status
1. / Witnessing Signature
Original passport or Emirates ID of the person signing the document / ☐
2. / Attestation of Documents as true copy
Original documents / ☐
3. / No Objection Certificate / ☐

Fee

Processing Fee / US$100 each document
Currency Conversion – US$ = AED3.6735

HowtoPay?

Please choose the preferred method of payment.
For Debit or Credit Card payment, please visit the Registrar’s office.
Bank Transfer
USD Account
Bank Name: National Bank of Abu Dhabi
Account Name: ADGM Registration Authority
Account Number: 6205791613
IBAN Number: AE280350000006205791613
AED Account
Bank Name: National Bank of Abu Dhabi
Account Name: ADGM Registration Authority
Account Number: 6205791532
IBAN Number: AE810350000006205791532

Wheretosubmittheform?

Completed form along with relevant supporting documents and fees can be submitted to:
The RegistrationAuthority Level 3
Abu Dhabi Global Market Building,
ADGM Square, Al MaryahIsland,
P.O.Box111999, Abu Dhabi, UAE

ForFurtherInformation,pleasecontactus.

Telephone Number / Email Address
+9712 3338888 /