CYRUS2 DOMREG

DOMAIN NAME BEING REGISTERED (Do not include www or http://) Domain Name: New registrations only Move or Modify existing registration Cyrus2 Cold Storage ORGANIZATION USING DOMAIN NAME Organization Name: Street Address: City: State: Postal Code: Country: ADMINISTRATIVE CONTACT JV464
BILLING CONTACT IF DIFFERENT FROM ADMINISTRATIVE CONTACT DO NOT FILL THIS IN PARTIALLY, EITHER LEAVE BLANK OR FILL IT IN COMPLETELY! NIC Handle if known: Name (Last, First): Individual or Role: Organization Name: Street Address: City: State: Postal Code: Country: Phone Number: Fax Number: E-Mailbox: