Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694878540145.pdf (Antigua and Barbuda)
Agent’s License Form AB7 The Government of Antigua and Barbuda Application for Registration as a Licensed Agent Citizenship by Investment Programme For Official Use Only Reference Number Agents License Number Date Received Version January 2022 | Copyright © 2013 Government of Antigua and Barbuda | All rights reserved | Copying this form is illegal Agent’s License Form Please read the following explanatory notes carefully.
In accordance with Section 4 of the Antigua and Barbuda Citizenship by Investment Act (2016), applications for citizenship shall be submitted only by an Agent who is the holder of an Agent’s License, issued by the licensing authority of the Citizenship by Investment Unit.

An Agent’s License may only be issued to a natural person who is a citizen of Antigua and Barbuda or who is lawfully ordinarily resident for a period of not less than seven years.
Professional indemnity cover must be held in the minimum sum of EC$ 3,000,000.

A Licensing Fee applies for all applications, as per the following prescribed schedule of fees: Schedule of Fees Application fee for Agent License Renewal fee, payable annually on the anniversary of the granting of the Agent’s License EC$ 8,100.00 EC$ 13,500.00 1.

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Please complete this form in BLOCK letters.

All fields are compulsory.


Please post or hand deliver the original completed application form, supporting documents and cheque to: The Citizenship by Investment Unit, Sir John E. St. Luce Finance and Conference Center, Factory Road, St. John’s, Antigua If the application form or the required documents received are not in order, the application may be rejected.

Please attach the following: For the Licensed Individual, please provide certified copies of the following documents: a. b.
Photo and data page of current valid passport (which must display personal data, signature and photograph) A utility bill (e.g.
electricity, telephone water) addressed personally to you at your principal residential address, issued in the last three months Evidence of professional indemnity cover held in the minimum sum of EC $3,000,000 A tax identification number issued by the Commissioner of Inland Revenue A police certificate (dated within 30 days of the date of submission of the license application) Confirmation of financial ability to carry on an agency business e.g.

bank statement.
bank statement.

c. d. e. f. Please attach a signed and dated cover letter (on headed paper as applicable) officially tendering this application.

This letter should detail the applicant’s professional qualification, ability, resources, experience and integrity and include certified true copies of any documentary evidence confirming the professional designation.

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Where the applicant is a member of a professional body, a certificate of good standing issued by the professional association to which he/she belongs is required.

Licensing Requirements An Agent shall maintain a place of business in Antigua and Barbuda and shall promptly inform the Unit of any changes in the location thereof.
An Agent’s license shall be revoked if- a) b) c) The ability, resources, experience or integrity of the Agent has fallen below the standard that might reasonably be expected; The annual fee remains unpaid for fourteen days after it has become due; The Agent no longer maintains a place of business in Antigua and Barbuda.

A person shall not be qualified to be an Agent if he/she is: a) b) c) d) A member of Parliament or a spouse, partner, or child of a member of Parliament.
A member of the Unit or a spouse, partner, or child of a member of the Unit.

Convicted of a criminal offence, involving fraud, money laundering, or being investigated of a criminal offence in Antigua and Barbuda, or any country outside Antigua and Barbuda.

A bankrupt, or his/her business is in receivership or has made arrangement with their creditors.
Note: A person who contravenes any subregulation of the Citizenship by Investment Act, or commits any other offence is liable on summary conviction to a fine not exceeding EC$ 20,000 or to imprisonment for a term not exceeding 12 months, or to both.
Version January 2022 | Copyright © 2013 Government of Antigua and Barbuda | All rights reserved | Copying this form is illegal Section A: Licensed Individual Applications are to be submitted by a Natural Person (as opposed to an organization) who is a citizen of Antigua and Barbuda, or who is lawfully ordinarily resident in Antigua and Barbuda for a period of not less than seven years.

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A1.

Title and full legal surname, as it appears on your passport  Mr  Mrs  Miss  Ms  Other ........................... A2.

Full legal first and middle names, as they appear on your passport A3.

Place of birth A4.

Country of birth A5.

Date of birth A6.

Gender D D M M Y Y Y Y  Male  Female A7.

Passport details Issuing country Passport number Place of issue Date of issue Date of expiration A8.
List all addresses where you have lived for the past 10 years (Note: Residences should include, without limitation, any place where you have lived for a period of 6 months or more) From (month/year) To (month/year) Street address, town, postal code, country A9.

Principal Residential Address A10.

Registered Office Address A11.

Email Address A12.

Website Address Version January 2022 | Copyright © 2013 Government of Antigua and Barbuda | All rights reserved | Copying this form is illegal A13.
Occupation A14.

Professional Association A15.

Professional Qualifications Held A16.

Signature Version January 2022 | Copyright © 2013 Government of Antigua and Barbuda | All rights reserved | Copying this form is illegal Version January 2022 | Copyright © 2013 Government of Antigua and Barbuda | All rights reserved | Copying this form is illegal