GaryNuman.Info Domain Information Form/Release
(Print and Fill Out)

Domain Name Requested -                             

Service Request -                             

(Sign this if you want us to transfer your domain from another ISP)

I hereby authorize any and all of the following to transfer the above-named domain name, to which I hold legal rights, from my current service provider to the Gary Numan Info Server: Joey Lindstrom, Robert Eggleston, Martin Purvis, and Ross Procter.

                            
Signature

                            
Date

(Sign this if you want us to register your domain name for you)

I hereby authorize any and all of the following to register the above-named domain name on my behalf: Joey Lindstrom, Robert Eggleston, Martin Purvis, and Ross Procter. Legal rights to this domain name remain mine.

                            
Signature

                            
Date

(All Web Hosting clients must sign this)

I hereby authorize any and all of the following to host the above-named domain name, on my behalf, on the Gary Numan Fan Server: Joey Lindstrom, Robert Eggleston, Martin Purvis, and Ross Procter. Legal rights to this domain name remain mine.

                            
Signature

                            
Date

If we are transfering your domain from another ISP, please write down any and all contact information about that ISP here, so that we can arrange the transfer: