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*indicates required field <br /> Optional 2nd Customer signature or Outsourcer Signature (if applicable) <br /> Customer I Outsourcer <br /> Name of Entity* Name of Entity* <br /> Signature* Signature* <br /> Printed Name* Printed Name* <br /> Printed Title* Printed Title* <br /> Signature Date* Signature Date* <br /> If Customer requires physical media, additional contacts, or is reporting multiple previous Enrollments, <br /> include the appropriate form(s) with this signature form. If no media form is included, no physical media <br /> will be sent. <br /> After this signature form is signed by the Customer, send it, along with completed documents, to <br /> Customer's channel partner or Microsoft account manager who must submit them to the following <br /> address. When the signature form is fully executed by Microsoft, Customer will receive a confirmation <br /> copy. <br /> Microsoft Licensing, GP <br /> Dept. 551,Volume Licensing <br /> 6100 Neil Road, Suite 210 <br /> Reno, Nevada USA 89511-1137 <br /> Prepared By: Scott Mangum (LS) <br /> .a V <br /> Volume Licensing Programs Signature Form Page 2 of 2 <br /> (North America)State and Local(English)September 3,2007 <br />