******* Please DO NOT REMOVE Version Number or Sections 1-8 ********

Domain Modify Version Number: 3.0

******* Email completed agreement to support@resellserv.com *******

Authorization

0a.  (N)ew (M)odify (D)elete (R)enew (T)ransfer....: Modify
0b.  Auth Scheme................:  PASSWORD (authInfo code)
0c.  Auth Info..................:  (note- type existing authInfo code here)
0d.  Auth Info...................: (note- type new autoInfo code here)

1.   Comments...................: 

2.   Complete Domain Name.......: 

Organization Using Domain Name

3a.  Organization Name..........:  (note- this item 3a cannot be changed using this form)
3b.  Street Address.............: 
3c.  City.......................: 
3d.  State......................: 
3e.  Postal Code................: 
3f.  Country....................: 

Administrative Contact

4b.  (I)ndividual (R)ole........: 
4c.  Name (Last, First).........: 
4d.  Organization Name..........: 
4e.  Street Address.............: 
4f.  City.......................: 
4g.  State......................: 
4h.  Postal Code................: 
4i.  Country....................: 
4j.  Phone Number...............: 
4k.  Fax Number.................: 
4l.  E-Mailbox..................: 

Technical Contact

5b.  (I)ndividual (R)ole........: 
5c.  Name (Last, First).........: 
5d.  Organization Name..........: 
5e.  Street Address.............: 
5f.  City.......................: 
5g.  State......................: 
5h.  Postal Code................: 
5i.  Country....................: 
5j.  Phone Number...............: 
5k.  Fax Number.................: 
5l.  E-Mailbox..................: 

Billing Contact

6b.  (I)ndividual (R)ole........: I
6c.  Name (Last, First).........: 
6d.  Organization Name..........: 
6e.  Street Address.............: 
6f.  City.......................: 
6g.  State......................: 
6h.  Postal Code................: 
6i.  Country....................: 
6j.  Phone Number...............:
6k.  Fax Number.................: 
6l.  E-Mailbox..................: 

Prime Name Server
7a.  Primary Server Hostname....: 
7b.  Primary Server Netaddress..: 

Secondary Name Server(s)

8a.  Secondary Server Hostname..: 
8b.  Secondary Server Netaddress: 

8a2.  Secondary Server Hostname..: 
8b2.  Secondary Server Netaddress: 

8a3.  Secondary Server Hostname..: 
8b3.  Secondary Server Netaddress: 

8a4.  Secondary Server Hostname..: 
8b4.  Secondary Server Netaddress: 

8a5.  Secondary Server Hostname..: 
8b5.  Secondary Server Netaddress: 


TERMS OF AGREEMNT

Incorporated by reference:
https://www.resellserv.com/terms.html

END OF AGREEMENT