Declaration. [To be made by organizations seeking from APNIC a change of registration details or a new maintainer object password]

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1 Form 1 Declaration [To be made by organizations seeking from APNIC a change of registration details or a new maintainer object password] I, of (full name) (address) declare that: 1. I am of/to (the Organization ) (position held or relationship to) (name of organization) and am duly authorized to make this declaration on behalf of the Organization. 2. The Organization requests that APNIC, takes the following actions, on behalf of the resource holder, with respect to the registration of the Internet address resources specified in Schedule A (the resources ): a. amend the registration details as specified in Schedule A b. issue a new maintainer object password to the Organization (indicate applicable actions) 3. To the best of my knowledge and investigations, the Organization is fully entitled to request this action, on the basis of the facts set out in Schedule B. Furthermore, to the best of my knowledge and investigations, no other organization or individual disputes, or is likely to dispute, either this entitlement or the custodianship of the resources. 4. To the best of my knowledge and investigations, all of the details contained in this declaration, including the Schedules and any other supporting documentation I have provided, are true and accurate. I make this declaration conscientiously believing it to be true. Signed and Declared by the above named declarant at in the State/Country of this..... day of Witnessed by:... (Signature of witness)... (Signature of declarant) (Name of witness) Declaration for organizations requesting change of registration details or a new maintainer object password (v1.0) 1

2 Schedule A [Please refer to the examples provided by APNIC] This and the following pages constitute the Schedule A referred to in the declaration of made before me this..... day of (Signature of witness). (Signature of declarant)..... (Name of witness) Details of Internet address resources The Organization requests that the following Internet address resource: [insert current registration object] be amended to: [insert desired registration object; if you are only requesting a new password for the object above simply enter new password ] Please attach extra pages for additional registration objects Declaration for organizations requesting change of registration details or a new maintainer object password (v1.0) 2

3 Schedule B [Please refer to the examples provided by APNIC] This and the following pages constitute the Schedule B referred to in the declaration of made before me this..... day of (Signature of witness). (Signature of declarant)..... (Name of witness) Summary of facts justifying requested action I believe the Organization is fully entitled to request the specified action, on the basis of the following facts: [briefly describe the relevant facts] Declaration for organizations requesting change of registration details or a new maintainer object password (v1.0) 3 of 3 3

4 Form 2 Agreement by Organization requesting change to registered details [This agreement is to be signed by duly authorized representatives of organizations requesting APNIC to change registered details or issue new passwords in respect of Internet address resources] General details Name of organization making request (the Organization ) Address for notices and legal correspondence: Street or postal address address RT# (APNIC use only) Recitals APNIC Pty Ltd ( APNIC ) is a non-profit proprietary limited company incorporated under Australian law. APNIC now maintains a publicly accessible Whois database that is considered by the global Internet addressing community to be the authoritative database for the registration of numeric Internet address resources to which APNIC has been delegated authority (directly or indirectly) by the Internet Assigned Numbers Authority (IANA), and for database objects related to those resources. The Organization is requesting that APNIC make changes to certain database registration objects and/or issue to the Organization new passwords relating to the maintenance of certain objects. In support of the Organization s request, the Organization provides to APNIC the documentation listed in the Schedule to this agreement and any other documentation sought by APNIC in the course of evaluating the request. 1

5 Terms and conditions The Organization requests APNIC to change certain database registration objects and/or issue new passwords relating to the maintenance of certain objects (the request ). The database registration objects and requested actions are described in Declarations provided with this agreement. In consideration of APNIC considering the request, the Organization agrees to the following terms and conditions. 1. Warranty of all information provided The Organization warrants that all information provided in connection with this request is true, accurate, and complete to the best knowledge and investigations of the Organization. The Organization agrees that if any of the information provided in connection with this request is subsequently found by APNIC to be substantially false or misleading, then APNIC has the right to amend any of the relevant database registration objects accordingly. This warranty applies to: the declarations and other documentation specified in the schedule to this agreement; other documentation provided to APNIC by the Organization at any time in connection with this request; all other statements and representations made by the Organization or its representatives in connection with this request. 2. Indemnity and liability a. To the extent permitted by law, APNIC excludes all liability to the Organization arising out of or in connection with this agreement, or the ongoing maintenance of the relevant database registration objects. This exclusion applies, without limitation, to all liability in contract or tort for actions or omissions of the APNIC and its employees, agents, and contractors. b. The Organization indemnifies APNIC against the full amount of all expenses, losses, damages, and costs that the Organization may incur as a result (directly or indirectly) of any actions taken by APNIC in accordance with the Organization s request. 3. Governing law This agreement is governed by the laws of Queensland, Australia. 2

6 Executed as an agreement: Signed for (Organization) by its authorized representative in the presence of: Signature of authorized representative Signature of Witness Full name of authorized representative (please print) Full name of Witness (please print) Official company title of authorized representative (please print) 3

7 Schedule of documentation provided to support request Type of document (declaration, employment contract, etc) Signed by (if applicable) Document date 4

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