| Interstellar
Domain Transfer Request |
| Note:
All information entered on this site is ENCRYPTED.
Double-click the secure lock [ ]
in the status bar for verification.
All required fields have a red star *. |
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*Domain name
1: |
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Domain name 2: |
 . |
Domain name 3: |
 . |
Domain name 4: |
 . |
Domain name 5: |
 . |
*Account
Password: |
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*Re-type
Password: |
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*Registration
Period in Years: |
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*Use:
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Custom
NameServers: |
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Renew the registration
of this domain name when it expires. (recommended)
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| Registrant
Information |
The
following information will become part of the official WHOIS
record registered with the root nameservers. Please enter
the domain's owner here.
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*First
Name: |
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*Last
Name: |
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*Address1:
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Address2:
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*City:
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US State: |
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Province: |
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Not Applicable |
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*Zip
Code: |
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*Country:
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Organization Name:
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Job Title:
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*Email
Address: |
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*Phone:
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Fax:
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| Credit Card Information |
*Credit
Card Type: |
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*Cardholder's
Name: |
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*Credit
Card Number: |
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*Expiration
Date: |
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Credit
Card Verification Number: |
 Help
locating number. |
*Required
if it is on your card.
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Usually the last 3 digits
on the back of the card.
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| Billing Address
Information (if different from that of Registrant) |
*Cardholder's
Street Address:
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City:
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US State: |
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Province: |
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Not Applicable |
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Zip
Code: |
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<>Country:
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| YOU
WILL BE CHARGED $25.00 PER YEAR
ALL SALES ARE FINAL |
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