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Registry-Registrar Agreement
detail
Please complete the details shown below before submitting.
Registrar Contact Details
Registrar Name
Registrar Information
Corporate Name
Street Address
City/Town
State/County/Region
Postal/Zip Code
Country
Phone Number
Fax Number
General E-Mail Address
Priority E-Mail Address
Website
Time Zone (from GMT)
Email address to which Domain Name Invoices and
monthly statements should be sent
VAT (Sales Tax) Number (EU Registrars only)
Space-separated list of IP addresses (or subnets) from which EPP Connections will be made
Live system
OTE system
Space-separated list of IP addresses (or subnets) from which WEB Connections will be made
Live system
OTE system
Administrative Contact for Registrar
Title
Mr
Mrs
Miss
First Name
Last Name
Job Title
Telephone No.
Email Address
Technical Contact for Registrar
Title
Mr
Mrs
Miss
First Name
Last Name
Job Title
Telephone No.
Email Address
Accounts Department Contact for Registrar
Title
Mr
Mrs
Miss
First Name
Last Name
Job Title
Telephone No.
Email Address