Official Seal

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:


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 passport sized photo 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:
Passport photo must be in 2 x 2 format
with white background. Click here for complete
passport photo standards.
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.
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