Application Form Business Postal Address General DataCompany Name*Chamber of Commerce number*Not registered yet? Then please enter I/O for In Creation.First Name*Last Name*Date of Birth Date Format: DD dash MM dash YYYY Place of BirthAddress* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone Number*E-mail* Preferred ServicesLocation*Veembroederhof 281 - AmsterdamKrijn Taconiskade 348-350 - AmsterdamImpuls 20 - PurmerendNetwerk 21 - PurmerendWilhelminalaan - PurmerendStart Date Service* Date Format: DD dash MM dash YYYY Initial Duration Service*3 months at € 60,00 per month6 months at € 58,00 per month12 months at € 55,00 per monthX number of chosen months are invoiced directly.Initial Duration Service*3 months at € 82,00 per month6 months at € 78,50 per month12 months at € 75,00 per monthX number of chosen months are invoiced directly.Post Package*1x per month NL 50 gram (free)€ 3,- ex. VAT - 1x p/month within the Netherlands€ 12,- ex. VAT - 1x p/week within the Netherlands€ 6,- ex. VAT - 1x p/month within the EU.€ 24,- ex. VAT - 1x p/week within the EU.For each package 'Post service maximum of 250 grams per delivery' applies.Personal/Company data regarding applicationLegal Form Company* Foundation, Sole Trader or VoF* BV or different Shares*Are there natural persons strong> who own 25% or more of the company's shares, directly or through a higher company in the company structure. Yes No Control*Are there natural persons strong> who hold 25% or more of the control (voting rights on shares) over the company, directly or through a higher company in the company structure. Yes No Factual Control*Are there natural persons strong> who have permission to exercise actual control over the company. Yes No Copy ID (jpg or png)*Copy of ID must be fully visible.Accepted file types: jpg, png.MessageI have taken note of the General Terms and Conditions.*General Terms and Conditions Yes, I have read them and agree. PhoneThis field is for validation purposes and should be left unchanged.