Application Form for applying for delegation of an Internet domain under .hu public domains

Disclaimer: 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 acknowedges that in case of any dispute the Hungarian official versions of the documents are the legally binding ones.

(Columns to be filled in on a mandatory basis are in bold letters)

Domain name chosen:

[ ] New application? [ ] New application with priority? [ ] Amendment? Reason: _________________

If the name is a trade mark, what is the registration number:

Under which public domain do you ask for the delegation?
[ ] .hu domain [ ] second level public domain, viz.:_________________

Identifier of the Domain Applicant (tax number of the entity (or for the lack thereof the registration number) or the personal (identity card) number of private individual:
Legal status of Domain Applicant:
Full name of Domain Applicant (in Hungarian):
Name in English (if not private person):
Postal address of Domain Applicant:
telephone number:
 telefax number:
e-mail address:

Administrative contact designated by Domain Applicant (if other than Domain Applicant)
name:
postal address:
telephone number:
 telefax number:
e-mail address:

Technical contact person
name:
postal address:
telephone number:
 telefax number:
e-mail address:

Primary name server for the domain Name:

IP address:

I declare that
• I am familiar with, accept and shall comply with the Domain Registration Rules and Procedures in force any time;
• I shall accept the decisions of the Registry and the Registrar in issues relating to the application for, delegation and maintenance of the domain;
• I acknowledge that in case of disputes relating to the conformity of the applications to the Domain Registration Rules and Procedures the Registrar and the Registry will submit themselves to the decision of the Consulting Board;
• I submit myself to the decision of the Alternative Dispute Resolution Forum in respect of issues relating to the chosen name of the domain, and I acknowledge that in a dispute on a domain name chosen by me I have the right to institute a legal redress action against the Dispute Applicant only and neither the Registrar nor the Registry shall be held liable for executing the decision of the Alternative Dispute Resolution Forum.
• I guarantee that I completed this Application Form with real data. I accept that the delegation of the domain is to be revoked in case the data provided were false or I fail to notify the Registrar about changes in data;
• I have filled in the application form genuinely and that I have perused it completely and signed it approvingly.

Date:
Name of the representative of the Applicant:
due signature:


Name of the Registrar: 3C