# DBIS MEMBERSHIP APPLICATION FORM ## Official Application for Membership in the Digital Bank of International Settlements **Form Number:** DBIS-MEM-APP-001 **Version:** 1.0 **Date:** [Enter date in ISO 8601 format: YYYY-MM-DD, e.g., 2024-01-15] **Classification:** CONFIDENTIAL **Authority:** DBIS Executive Directorate --- ## INSTRUCTIONS 1. Complete all sections of this application form 2. Attach all required supporting documentation 3. Submit to DBIS Executive Directorate at the address specified below 4. Retain a copy for your records --- ## PART I: APPLICANT INFORMATION ### Section 1.1: Entity Information **Official Name of Entity:** [Enter official name in English and original language if different] **Legal Status:** - [ ] Sovereign State - [ ] International Organization - [ ] Regional Organization - [ ] Other (specify): _________________________ **Date of Establishment:** [Enter date in ISO 8601 format: YYYY-MM-DD] **Jurisdiction of Incorporation/Establishment:** [Enter jurisdiction] **Legal Address:** [Enter complete legal address] **Mailing Address (if different):** [Enter complete mailing address] **Website:** [Enter official website URL] --- ### Section 1.2: Contact Information **Primary Contact Person:** - Name: _________________________ - Title: _________________________ - Email: _________________________ - Phone: _________________________ - Address: _________________________ **Alternate Contact Person:** - Name: _________________________ - Title: _________________________ - Email: _________________________ - Phone: _________________________ --- ## PART II: LEGAL AUTHORITY ### Section 2.1: Authority to Apply **Question:** Does your entity have legal authority to enter into international agreements and become a member of international organizations? - [ ] Yes - [ ] No **If Yes, provide documentation:** - [ ] Constitutional provisions - [ ] Statutory authority - [ ] Executive authority - [ ] Other (specify): _________________________ **Attach:** Legal documentation demonstrating authority (see required documents list) --- ### Section 2.2: Ratification Authority **Question:** What authority is required to ratify membership in your entity? - [ ] Executive authority only - [ ] Legislative approval required - [ ] Referendum required - [ ] Other (specify): _________________________ **Estimated Timeline for Ratification:** [Enter estimated timeline in days/months] --- ## PART III: ACCEPTANCE OF DBIS DOCUMENTS ### Section 3.1: Charter Acceptance **Question:** Do you accept the DBIS Constitutional Charter in its entirety? - [ ] Yes, I accept the DBIS Constitutional Charter - [ ] No (if no, explain): _________________________ **Signature:** _________________________ **Date:** [YYYY-MM-DD] **Title:** _________________________ --- ### Section 3.2: Articles Acceptance **Question:** Do you accept the DBIS Articles of Governance in their entirety? - [ ] Yes, I accept the DBIS Articles of Governance - [ ] No (if no, explain): _________________________ **Signature:** _________________________ **Date:** [YYYY-MM-DD] **Title:** _________________________ --- ### Section 3.3: Statutory Code Acceptance **Question:** Do you accept the DBIS Statutory Code (Titles I-XX) in its entirety? - [ ] Yes, I accept the DBIS Statutory Code - [ ] No (if no, explain): _________________________ **Signature:** _________________________ **Date:** [YYYY-MM-DD] **Title:** _________________________ --- ## PART IV: FINANCIAL INFORMATION ### Section 4.1: Financial Capacity **Annual Budget (most recent fiscal year):** - Currency: _________________________ - Amount: _________________________ - Fiscal Year: _________________________ **Total Assets (most recent):** - Currency: _________________________ - Amount: _________________________ - Date: [YYYY-MM-DD] **Total Liabilities (most recent):** - Currency: _________________________ - Amount: _________________________ - Date: [YYYY-MM-DD] **Net Worth:** - Currency: _________________________ - Amount: _________________________ --- ### Section 4.2: Initial Contribution Commitment **Proposed Initial Contribution:** - Currency: _________________________ - Amount: _________________________ - Payment Method: _________________________ - Payment Timeline: _________________________ **Note:** Initial contribution amounts are determined by DBIS based on entity size and capacity. This is a proposed amount subject to DBIS determination. --- ### Section 4.3: Annual Membership Fee Commitment **Question:** Do you commit to paying annual membership fees as determined by DBIS? - [ ] Yes - [ ] No **Estimated Annual Fee Capacity:** - Currency: _________________________ - Amount: _________________________ --- ## PART V: OPERATIONAL CAPACITY ### Section 5.1: Operational Resources **Number of Personnel:** - Total: _________________________ - Available for DBIS-related activities: _________________________ **Technical Capabilities:** - [ ] Digital infrastructure - [ ] Financial systems - [ ] Security systems - [ ] Other (specify): _________________________ --- ### Section 5.2: Integration Readiness **Question:** Are you prepared to integrate with DBIS systems and procedures? - [ ] Yes, fully prepared - [ ] Yes, with some preparation needed - [ ] No, significant preparation required **Estimated Integration Timeline:** [Enter estimated timeline in months] **Integration Support Needed:** [Describe any support or assistance needed] --- ## PART VI: COMMITMENT TO DBIS PURPOSES ### Section 6.1: Purpose Alignment **Question:** How does your entity align with DBIS purposes? [Provide detailed explanation of alignment with DBIS purposes] --- ### Section 6.2: Potential Contribution **Question:** What potential contribution can your entity make to DBIS? [Describe potential contributions in areas such as: - Financial resources - Technical expertise - Operational capabilities - Geographic presence - Other contributions] --- ## PART VII: REQUIRED DOCUMENTATION ### Section 7.1: Documentation Checklist **Required Documents (attach copies):** - [ ] Legal authority documentation (constitutional provisions, statutes, etc.) - [ ] Entity registration or establishment documents - [ ] Most recent audited financial statements (last 3 years) - [ ] Organizational structure document - [ ] Authorized representative credentials - [ ] Proof of legal existence - [ ] Other documents as requested **Note:** All documents must be in English or accompanied by certified English translations. --- ## PART VIII: DECLARATIONS ### Section 8.1: Accuracy Declaration I hereby declare that all information provided in this application is accurate and complete to the best of my knowledge. **Signature:** _________________________ **Name:** _________________________ **Title:** _________________________ **Date:** [YYYY-MM-DD] --- ### Section 8.2: Authority Declaration I hereby declare that I have the authority to submit this application on behalf of the entity named above. **Signature:** _________________________ **Name:** _________________________ **Title:** _________________________ **Date:** [YYYY-MM-DD] --- ### Section 8.3: Commitment Declaration I hereby declare that, if accepted as a member, the entity will fulfill all membership obligations as specified in the DBIS Charter, Articles, and Statutory Code. **Signature:** _________________________ **Name:** _________________________ **Title:** _________________________ **Date:** [YYYY-MM-DD] --- ## PART IX: SUBMISSION ### Section 9.1: Submission Information **Submission Method:** - [ ] Electronic submission (email to: applications@dbis.org) - [ ] Physical submission (mail to address below) - [ ] Both electronic and physical **Submission Date:** [Enter date in ISO 8601 format: YYYY-MM-DD] **Submission Address:** DBIS Executive Directorate Membership Applications Office [Enter DBIS address] --- ### Section 9.2: Acknowledgment **Application Received By:** [DBIS staff to complete] **Receipt Date:** [DBIS staff to complete] **Application Number:** [DBIS staff to assign] **Acknowledgement Signature:** [DBIS staff signature] --- ## NOTES 1. Incomplete applications will be returned for completion 2. False or misleading information may result in application rejection 3. All information will be treated as confidential per DBIS security classification 4. Application review typically takes 120-150 days 5. Questions may be directed to: applications@dbis.org --- **END OF MEMBERSHIP APPLICATION FORM**