Registrar Accreditation Application Form /

HOW TO FILL AND FILE THIS FORM:

This form is a request for proposals. An application to become an accredited registrar for domain names under the .co.il & .org.il SLDs (the "Application") shall be filed with the Internet Association ("ISOC-IL") in writing, using this form only. A check of NIS 2,000 for nonrefundable handling fees shall be attached. The Application shall include all the details specified below, printed. The applicant shall sign each page of this form. Three copies are to be filed with ISOC-IL offices, signed by the applicant and approved by the applicant's attorney. In addition, the applicant shall forward to , a copy of the filled-in form and its attachments (scanned as PDF or TIFF documents – at minimum resolution of 150 dpi).

Please note:

Filing the Application and its attachments with ISOC-IL, constitutes a proposal by the applicant to serve as an Accredited Registrar. ISOC-IL may, at its absolute discretion, accept the applicant's proposal, reject it, subject its acceptance to terms and conditions, or withhold its processing. Therefore, filing an Application and paying the handling fees does not oblige ISOC-IL to accept the applicant's proposal, nor does it oblige acceptance at any particular time or manner. For the avoidance of doubt - only an agreement properly signed by both parties, the wording of which is designated by ISOC-IL, shall constitute an acceptance on behalf of ISOC-IL. Any other notice, written or verbal by ISOC-IL or whomever on its behalf, is not to be regarded as such.

APPLICANT'S DETAILS▼
P.C. no. / Company's name
City / No. / Street
email / Zip Code CodeCode / POB
Website / Fax / Telephone
CONTACT PERSON ON BEHALF OF THE APPLICANT, authorized to bind the applicant by signature▼
ID no. /

Surname

/ First name
Position
Direct fax / Direct phone
Cellular phone / Email
Shareholders holding more than 5% of the issued capital*▼
ID no./P.C. no. /

Address

/ name
ID no./P.C. no. /

Address

/ name
ID no./P.C. no. /

Address

/ name
COMPANY'S BOARD MEMBERS*▼
ID no. /

Address

/ name
ID no. /

Address

/ name
ID no. /

Address

/ name
CEO & SENIOR STAFF of the company*▼
Address / ID No. /

Name

/ Position
Address / ID No. /

Name

/ Position
Address / ID No. /

Name

/ Position
PERSON IN CHARGE OF REGISTRAR'S ACTIVITY in the company ▼
Address / ID No. / Name
CRIMINAL CONVICTIONS* ▼
The applicant hereby declares that he, as well as the person nominated to be in charge of registrar activity, were not convicted of any criminal offence. If the applicant is a corporation –none of its acting directors or the controlling shareholder of the corporation were so convicted. For this matter, "offence" – other than an offence according to the transportation regulations; "convicted of an offence" – includinganyone against whom an indictment has been filed and a final verdict is yet to be given. In the case of conviction, the offences are to be specified below
Date of conviction / Details of the offences / Name
Date of conviction / Details of the offences / Name
Date of conviction / Details of the offences / Name

Certified copies of the incorporation instruments – approved and authenticated by an attorney - are to be attached (articles of association, registration certificate and a certificate for a change of name – if applicable) In addition, an up-to-date printout issued by the Registrar of Companies is to be attached.

DESCRIPTION OF THE COMPANY'S BUSINESS*▼
Yes No / Applicant provides registration services for Domain Names? / No. of employees / Incorporation Date
If the applicant – or any of its employees – supply such registration services or did so in the past, please specify - Since when, by/through which site/s, to which TLDs*:
Fields of company's business

An Accountant's approval, the wording of which is attached as Appendix A, is to be submitted with this form of application.

DOMAIN NAMES HELD BY THE COMPANY▼All domain names - in full, under all TLDs, which are registered in the company's name or any trustee thereof – are to be specified*

Add to the application a detailed description of the following:

  • Computerized and communication systems, management, personnel and services that are to officiate the Registrar's activities;
  • In particular – a description of systems and procedures for data protection, electronic data backup and redundancy in the communication and computer systems that are to serve the Registrar's activity (including a drawing of the computers and communication layout(

CONFIRMATION & AGREEMENT▼
By signing this application we hereby confirm and approve our consent to the following:
  • Rejection of the application shall not grant us a refund of handling fees that are hereby paid to ISOC-IL
  • We acknowledge and agree that this application is merely a proposal to ISOC-IL. ISOC-IL is entitled, at its own discretion, to decide whether to accept the proposal, reject it or accept it under certain terms, conditions or stipulations; in no case is ISOC-IL, while reviewing this proposal at its discretion, bound or restricted by any guiding rules; ISOC-IL is not obliged whatsoever to accept the proposal, nor to do so at any particular date; only an Accredited Registrar agreement signed both by ISOC-IL and by us, shall constitute a binding agreement;
  • If ISOC-IL decides to accept the proposal under stipulations, this shall be regarded as a request for a proposal from us. In such case, we are to inform ISOC-IL, in writing, within ten (10) business days from the notice, whether we are willing to amend our proposal to meet ISOC-IL's stipulations. If we do not notify ISOC-IL within the abovementioned time period that we are willing to meet its terms, it shall be regarded as refusal, and in which case, our original proposal shall be regarded as declined, unless ISOC-IL has given its agreement in advance and in writing, to extend the proposal's validity;
  • We have read and are familiar with the wording and terms of agreement between ISOC-IL and whomever it may chose as an Accredited Registrar, and if ISOC-IL decides to accept our proposal and sign an Accredited Registrar Agreement with us, we meet the Agreement's demands and conditions, and are able to withstand them;
/
  • that these details inter alia, will be considered by ISOC-IL when forming its decision whether to enter into an Accredited Registrar with us. We shall indemnify and compensate ISOC-IL and any other third party, for damages which may be caused due to inaccuracy, error or the omission of details in this form of application.
  • The undersigned on behalf of the applicant is an authorized representative and his/her signature below is valid and binding upon the Applicant;
  • No proposal on our behalf was filed to ISOC-IL and rejected, within the six (6) months prior to the present proposal;
  • No conflict of interests exists between us and any other applicant or otherwise Accredited Registrar already approved by ISOC-IL;
  • We are not in debt of any sort to ISOC-IL;
  • We posses the technical means – including computer systems, communication, data protection, software, hardware and infrastructure – that are required for carrying out the role of an Accredited Registrar, in case ISOC-IL chooses to sign such an agreement with us;
  • The details specified in this application, its annexes and the attached documents are complete, updated and accurate. We are aware
  • As long as no written agreement is signed (if at all signed) between us and ISOC-IL, we may – at any time – withdraw and cancel this application

SIGNATURE ▼
I hereby confirm the correctness of the details in this application, and the applicant's consent to its stipulations and conditions.
______
Date / ______
Company's stamp & Signature

Attorney Confirmation

I hereby verify the correctness and validity of my client's signature on this form of application:

______/ ______/ ______/ ______
Stamp & Signature / License no. / Address / Name of Attorney

APPENDIX A

Date:

Israel Internet Association (ISOC-IL)

6 Bareket St.

Petach Tikvah49517

ISRAEL

Dear Sir/Madam,

Re: [1]

As the accountant of the company whose details are mentioned above ("Company"), I hereby confirm the following:

1.I affirm that my confirmation is a part of the Company's request from the Israel Internet Association (ISOC-IL) to become an accredited registrar for the .il ccTLD, which will be inspected by ISOC-IL.

2.Company's total income, in each of the three calendar years preceding the date of this confirmation, has been as follows:
YearTurn-over (in NIS)[2] Is balance sheet controlled?

______controlled not-controlled

___ controlled not-controlled

___ controlled not-controlled

____

3.The Company's equity deficiency in the Company's balance sheet for the calendar year ended prior to the issuance of this confirmation is: NIS .

Sincerely,

______

Signature + Stamp

CPA Information

Name:

Address:

Phone:

Fax:

Email:

ISRAEL INTERNET ASSOCIATION (ISOC-IL) | 6 Bareket St., p.o.b 720, Petach-Tikvah 49517 | Tel: +972-3-970090 | Fax: +972-3-9700901|

[1]Name of Applicant, as appears on Application Form

[2] As appears in Company's balance sheet