Evaluation process for recognition of Blockchain Entity

The application form consists of mandatory and optional questions. You will need to complete and submit the online form in a single session. After you press “Send your Application Form”, you will not be able to modify the application. We recommend providing as many details as possible, in line with the information currently in your possession. The outcome of the evaluation will depend on the quality of the data submitted under each part of the application

A fully completed application ensures the assessment is as reliable and representative of reality as possible. Applications with incomplete questions and/or documents will not be considered. Download the questions to prepare the application before filling and submitting : http://bit.ly/33PcvUo

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Email

Phone

Country

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1) Business name

2) Tax identification number

3) Date of incorporation

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DD

YYYY

4) Place of incorporation

5) Headquarter and local branches

6) Corporate purpose

7) Brief description of the activity

8) Investments in research, development and innovation?

Yes

No

9) If yes, please attach an analytical description of expenses in research and development and investment in innovation.

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10) Please attach the list of shareholders all individuals and legal entities.

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11) Please attach the list of beneficial owners, including third parties on whose behalf, in the interests of, or under the control of which, the shareholder acts.

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12) Do you have controlled or associated companies?

Yes

No

13) If yes, please attach a disclosure of shareholdings in other companies.

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14) Do you have professional, cooperative or commercial relations with institutional investors, professionals, university, research institutes or other?

Yes

No

15) If yes, please attach an analytical description of the type of contribution and the type of involvement in the project.

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16) Last published financial statement.

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17) Indicate the type of blockchain used, describing the main technical features

18) Will you settle a trust?

Yes

no

19) If yes, please identify the trustee and the fundamental elements of the new structure.

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20) Please attach additional documents which you consider useful for the assessment of the application.

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To start the evaluation process a fee of € 1.500 is due to San Marino Innovation as prescribed by the relevant Directive. In case of a positive result, the evaluation fee will be deducted from the annual registration fee applicable to the Blockchain Registry. In the case of a negative result, an invoice related to the evaluation process will be issued.

The fee must be paid to the Cassa di Risparmio della Repubblica di San Marino S.p.A., Dogana Branch headed to the following account: Republic of San Marino Innovation Institute IBAN: SM 27 W 06067 09803 000030153426 Reason: Start of the evaluation process for recognition of Blockchain Entity or by credit card http://bit.ly/2RJklMy

21) Please, upload payment receipt

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