Application for a Domain Name Registration

makeshiftklipInternet and Web Development

Oct 31, 2013 (3 years and 8 months ago)

74 views

Application for a Domain Name Registration

Under the Top Level Domain .kh

---------------------------------------------------------

1. Owner type (please select one)





individual













company









organization



-


2. E
-
mail address of person c
ompleting this form:



3. The domain name being requested


-


4. The Applicant

4a. Name ( full legal name of the organization as it appears on legal documents):



-

4b. Postal Address:


-

4c. Telephone Nº:


-

4d. Telefax Nº:



-


5. Admin
istrative Contact Person (This person will be the contact for all subsequent

correspondence regarding this Domain)

5a. Name:


-


5b. Postal Address:


-


5c. Telephone Nº:

-


5d. Telefax Nº:



-


5e. E
-
Mail Address (present e
-
mail address if applicable, or
intended e
-
mail address after new
domain name registration is completed):



6. Technical Contact (This person will be the technical contact point for the Domain
administration. This is the contact point for operational problems concerning the Domain. If th
e
Technical Contact is the same as the

Administrative Contact, please enter "Same as Administrative
Contact").

6a. Name :


-


6b. Postal Address :

-


6c. Telephone Nº :


-


6d. Fa
x Nº :


-



6e. E
-
Mail address (present e
-
mail Address if applicable, or inte
nded e
-
mail address after new
domain name registration is completed):


service@flash
-
it.tw

7.

Billing contact

7a. Name:

-



7b. Postal Address:

-


7c. Telephone Nº:

-


7d. Telefax Nº:


7e. E
-
Mail Address



-


8. Name Server Information (Please contact your Tec
hnical Contact for the relevant information)

-
The Applicant must provide at least two independent servers for the

requested Domain that provide the Domain service for translating names to

IP addresses for hosts in this Domain.
-
In order to maintain safe Dom
ain Name Services it is
necessary to have the

Primary and the Secondary Domain Name Servers in physically separate

locations and on different networks.
-
These servers must be already configured and
running before

the submission of this form.

8a. Primary Ser
ver Hostname (including Domain):


-


8b. Primary Server IP Address:



-


8c. Secondary Server Hostname (including Domain):

-



8d. Secondary Server IP Address:


-


9. Optional additional Secondary Server Hostname (including Domain):




9a. Optional additio
nal Secondary Server IP Address:



9b. Optional second additional Secondary Server Hostname

( including Domain):



9c. Optional second additional Secondary Server IP Address:



9d. Additional Information (if you have any other information to annotate to th
is request please add
it here):



-

Incorrect or incomplete information supplied on this form may result in a Domain Name
Application being rejected, or the Domain Name may be removed even after registration.

-

Once this form has been submitted, you will
be sent e
-
mail indicating that the form has been
accepted, and that your request is processing.



10. By submitting your request you warrant:

-

The information supplied in the request is true and correct.

-

The application is made with the authority of the

Applicant.

-

You have read and accepted the "Regulations for Registering a Domain

Name under the Top Level Domain .kh" .

-

Any changes would be required a new application and considered as new registration.



11. The party requesting registration of this
name certifies that to her/his

knowledge, the use of this name does not violate trade name or other statutes. Registration of a
Domain Name does not confer any legal rights to that name

and any disputes between parties over the rights to use a particular n
ame are

to be settled between the contending parties using normal legal methods.

12. Certification

-

Application form must be submitted by e
-
mail to dns
-
admin@dns.net.kh .

-

License or certificate of trade name must be shown upon request by the DNS Adminis
trator (the
original copy must be presented for sighting or the photocopy is certified by the Phnom Penh
municipality).

-

The Domain name registration will be completed upon receipt of your initial Domain Registration
Payment.





DNS Administrator

Top Lev
el Domain.kh

Telephone number 023

725384