HI-TEK MULTIMEDIA, INC DOT VN, INC 9449 Balboa Ave., Suite 103, San Diego, CA 92123 - USA Fax: (858) 571-8497 Email: [email protected] Website: www.Hi-TekMultimedia.com 9449 Balboa Ave., Suite 103, San Diego, CA 92123 - USA Fax: (858) 571-8497 Email: [email protected] Website: www.DotVN.com FORM FOR CHANGING .VN REGISTRAR (Transfer – Out) 1. Domain Name (“DN”) Only one Domain Name request per Form – All Transfer-out requests must use this the official Hi-Tek Form 2. Expiration Date 3. Registrant (DN’s owner) Name of Owner Responsible Individual Email Address Tel / Fax 4. Administrative Contact Name Email Address Tel / Fax 5. Technical Contact Name Email Address Tel / Fax 6. Billing Contact Name Email Address Tel / Fax 7. Current Registrar Name of Current Registrar Email Address Tel / Fax 8. Current Reseller Hi-Tek Multimedia, Inc. (Dot VN, Inc.) [email protected] 9449 Balboa Avenue, Suite 103, San Diego, CA 92123 +(858) 571-2007 / +(858) 571-8497 (if appropriate) Name of Current Reseller Email Continued on next page Page 1 of 5 FORM FOR CHANGING .VN REGISTRAR (Transfer – Out) continued 9. New Registrar Name of New Registrar Email Address Tel / Fax 10. New Reseller (if appropriate) Name of Current Reseller Email Note: 1. 2. 3. 4. 5. 6. To complete the procedure for transferring the domain name, the owner has to fulfill all the following steps and submit the request to [email protected]: The Domain Name expiration date must be more than 60 days after the date this request is submitted; if not the Domain Name registration must first be renewed for one (1) year. Payment of the $100 USD transfer-out service cost by credit card and submission of the HiTek/Dot VN “Credit Card Payment Authorization Form” must accompany this Transfer-Out request. Submission of the official Hi-Tek/Dot VN “Authorization for .VN Registrar Transfer-Out” document must accompany this Transfer-Out request. Agree to the termination of the service agreement and all responsibilities of the existing Registrar HI-TEK MULTIMEDIA, INC./DOT VN, INC., (and its Reseller) with respect to the Domain Name stated above. This “Form for Changing .VN Registrar” and the “Authorization for .VN Registrar Transfer-Out” are valid for thirty (30) days from the date first signed by the registrant. Confirm the accuracy of the information provided above by signing, dating, and affixing seal below. Registrant (domain name owner) Confirmed by Current Registrar Name Signature Print Name/Title Date Affix Seal Current Reseller (if appropriate) Name Signature Print Name/Title Date Affix Seal Authorization Code Assigned by VNNIC Page 2 of 5 HI-TEK MULTIMEDIA, INC DOT VN, INC 9449 Balboa Ave., Suite 103, San Diego, CA 92123 - USA Fax: (858) 571-8497 Email: [email protected] Website: www.Hi-TekMultimedia.com 9449 Balboa Ave., Suite 103, San Diego, CA 92123 - USA Fax: (858) 571-8497 Email: [email protected] Website: www.DotVN.com AUTHORIZATION FOR .VN REGISTRAR TRANSFER-OUT TO: HI-TEK MULTIMEDIA INC./DOT VN, INC., From: Name of Registrant: …………………………………………………………………………… Proof of identity by attaching a copy of either a) Drivers License / Passport Number (individual only): …………………………………………, or b) Business License Number (business only): ………………………………………………………… and name of authorized individual: ………………………………………………………… Email Address: ………………………………………………………………………………………… Address: ………………………………………………………………………………………………… Tel: ……………………………… Fax: ……………………………… I/we registered the .VN domain name: …………………………………………………………………. on dated: …………………………… and having an expiration date of: …………………………… currently managed and renewed with HI-TEK/DOT VN or its Reseller (………………………… ………………………) I/we have authorized payment of the $100 USD transfer service cost by credit card and have attached the completed Hi-Tek/Dot VN “Credit Card Payment Authorization Form” with this Transfer-Out request. Now, I/we ask to transfer the domain name stated above to a new Registrar namely: ……………….. …………………………………………………………………………………………………………… 1. I/we guarantee for the Domain Name stated above which is requested to be transferred that: - There are no disputes and the Domain Name’s use is in full compliance with the regulations of Vietnam regarding the use of the Internet and domain names until the date of the transfer request. - There are no outstanding financial obligations with HI-TEK/DOT VN or its Reseller - After receiving the signed “Form for Changing .VN Registrar” the service agreement with HITEK/DOT VN or its Reseller is automatically terminated with respect to the Domain Name stated above; if there is a subsequent request for services from HI-TEK/DOT VN or its Reseller, I/we will sign a new service agreement with HI-TEK/DOT VN or its Reseller. 2. I/we take full responsibility for my Domain Name upon the acceptance of HI-TEK/DOT VN by its signing and affixing its seal to the “Form for Changing .VN Registrar”. Page 3 of 5 Therefore, I/we would like HI-TEK/DOT VN to give its consent to transfer-out my Domain Name as requested above and documented on the “Form for Changing .VN Registrar” Yours Sincerely, Registrant (domain name owner) Signature Print Name Date Affix Seal Note: 1. 2. 3. 4. 5. 6. To complete the procedure for transferring the domain name, the owner has to fulfill all the following steps and submit the request to [email protected]: The Domain Name expiration date must be more than 60 days after the date this request is submitted; if not the Domain Name registration must first be renewed for one (1) year. Payment of the $100 USD transfer-out service cost by credit card and submission of the Hi-Tek/Dot VN “Credit Card Payment Authorization Form” must accompany this Transfer-Out request. This “Authorization for .VN Registrar Transfer-Out” document must accompany the official HiTek/Dot VN “Form for Changing .VN Registrar”. Agree to the termination of the service agreement and all responsibilities of the existing Registrar HITEK MULTIMEDIA, INC./DOT VN, INC., (and its Reseller) with respect to the Domain Name stated above. This “Authorization for .VN Registrar Transfer-Out” and the “Form for Changing .VN Registrar” are valid for thirty (30) days from the date first signed by the registrant. Confirm the accuracy of the information provided above by signing, dating, and affixing seal above. Page 4 of 5 HI-TEK MULTIMEDIA, INC DOT VN, INC 9449 Balboa Ave., Suite 103, San Diego, CA 92123 - USA Fax: (858) 571-8497 Email: [email protected] Website: www.Hi-TekMultimedia.com 9449 Balboa Ave., Suite 103, San Diego, CA 92123 - USA Fax: (858) 571-8497 Email: [email protected] Website: www.DotVN.com CREDIT CARD PAYMENT AUTHORIZATION FORM I authorize DOT VN, INC. (DBA: HI-TEK MULTIMEDIA, INC.) at 9449 Balboa Ave., Suite 103, San Diego, CA 92123 to make one time charge to my credit card as described below: Customer Information: Registrant Name: Domain Name: Amount Authorized for transfer service cost: $100.00 USD Card Billing Information: Cardholder Name: Billing Address: City, State, Zip: Country: Phone: Fax: Email: Visa / MasterCard Only Account Type: Cardholder Name: Account Number: Expiration Date: CVV (3 digit number on back of Visa / MasterCard): I authorize the above named supplier to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form. Authorized Signature Date Note: This authorization must accompany the official Hi-Tek/Dot VN “Form for Changing .VN Registrar”. Page 5 of 5
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