Republic of New Lemuria

eCITIZENSHIP AND PASSPORT APPLICATION CLICK HERE FOR FILL-IN ACROBAT FORM

(You can submit this form online. Download Acrobat form above to print and mail in.)   Date: Applicant Surname (last): Applicant Given Names (first & middle): Current Address: City: State: Zip/Postcode: Country: Telephone: Fax: Email Address: Place of Birth: Date of Birth: Sex: Nationality: Hair Color: Eyes: Weight: Height: Profession: Occupation: Birth Name: Name of Father: Name of Mother: Professional Reference(s) (if applicable): Personal Reference(s): Bank Reference (if applicable): Brief statement why applicant wishes to become citizen of Republic of New Lemuria: Applicant Requires Driver's Permit: Yes No Applicant Requires International Driver's Permit: Yes No Applicant Requires I.D. Card: Yes No ATTESTATION OF UNDERSTANDING AND CERTIFICATION OF INFORMATION. Applicant understands that the Republic of New Lemuria ("Republic of New Lemuria") accepts no responsibility for the position of any government with regard to any Republic of New Lemuria passport and/or other identification documents. Applicant further declares that the information on this application is true and correct. Applicant hereby declares that he/she is familiar with the content found on the Republic of New Lemuria website at http://newlemuria.org, its Terms of Use and the Constitution of the Republic of New Lemuria. IMPORTANT: Applicant under 16 years of age must have the Attestation of Understanding signed by a parent or guardian. BY MY ELECTRONIC SIGNATURE HERETO, I CERTIFY THE FACTS STATED IN THIS APPLICATION TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. BY MY ELECTRONIC SIGNATURE HERETO, I PROMISE TO LIVE ACCORDING TO THE PRINCIPLES, CONSTITUTION AND LAWS OF THE REPUBLIC OF NEW LEMURIA AND HEREBY TENDER MY IRREVOCABLE PROXY TO THE REPUBLIC OF NEW LEMURIA'S HOUSE OF ELDERS TO VOTE ON MY BEHALF AT ALL FUTURE REPUBLIC OF NEW LEMURIA ELECTIONS. Upload a 2 x 2 passport sized white background photo (click for photo requirements) and a copy of your birth certificate (if not available, some other form of legal identification). Upon approval you will be notified of the immigration fees (your financial help is needed to build the Republic of New Lemuria). Note: Not all applications will be accepted. Upload Birth Cert / Ident: Upload Passport Photo: Online Signature:* * Type your name inside forward slashes, (e.g., /First Middle Last Name/ ) to signify your affirmative consent to sign this Citizenship and Passport Application electronically. Your electronic signature herein binds you to all of the terms, conditions, attestations, understandings and certifications contained in your electronically signed application as if signed by pen. DO NOT ELECTRONICALLY SIGN THIS DOCUMENT IF YOU DO NOT ACCEPT ALL CONDITIONS. Image Verification Please enter the text from the image [ Refresh Image ] [ What's This? ] Downloaded Citizenship and Passport Applications should be completed and mailed, together with two (2) properly formatted white background passport photos (click for photo requirements) and birth certificate (or other form of identification) to:   IMMIGRATION AND CITIZENSHIP SERVICES Government of the Republic of New Lemuria Embassy-at-Large 585 Box Canyon Road Canoga Park, California 91304 United States