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INSTRUCTIONS

Fax to:
GKG.NET, INC. • FAX: 281-617-5825
I. Domain Information:
Domain Information
Please provide your transfer information in the appropriate fields below.

Domain Name 1:  
Registrant Contact GKG Username:  
Administrative Contact GKG Username:  
Technical Contact GKG Username:  
Billing Contact GKG Username:  
Create GKG Username

Domain Name 2:  
Registrant Contact GKG Username:  
Administrative Contact GKG Username:  
Technical Contact GKG Username:  
Billing Contact GKG Username:  
Create GKG Username

Domain Name 3:  
Registrant Contact GKG Username:  
Administrative Contact GKG Username:  
Technical Contact GKG Username:  
Billing Contact GKG Username:  
Create GKG Username



II. Payment Information
Payment Information
Please provide your transfer information in the appropriate fields below.

Credit Card Number:  
Expiration Date:  
Name on Card:  
Billing Address:  
City/State/Postal:  
Country:  
Price*:  

*your transfer price must match your domain registration price



III. Reseller Identification
Reseller Identification
Please provide your transfer information in the appropriate fields below.

Reseller GKG Username:  



I understand that all customers are required to agree to all current GKG Registration Agreements and Policies as listed on their website. By signing and submitting this form, I consent to be bound by all GKG Registration Agreements and Policies. I further acknowledge that I am either the Registrant or an Authorized Agent acting on behalf of the Registrant of the attached or previously listed domains. I also understand that I am authorizing GKG to charge the credit card that will be used to pay for this transfer and that GKG will appear on my credit card statement with a charge corresponding with the above price field.

X  
 Date:  
Signature of Registrant or Authorized Agent of Registrant

Print Name: Phone:
Email:
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