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<br />TaxlD <br /> <br />Effective Date <br />(may be different than Microsoft's signature date) <br /> <br /> <br />* indicates required field <br /> <br />Optional 2nd Customer signature or Outsourcer Signature (if applicable) <br /> <br />Customer I Outsourcer <br /> <br />Name of Entity * <br /> <br />Name of Entity * <br /> <br />Signature * <br /> <br />Signature * <br /> <br />Printed Name * <br /> <br />Printed Name * <br /> <br />Printed Title * <br />Signature Date * <br /> <br />Printed Title * <br />Signature Date * <br /> <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 /> <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 /> <br />Microsoft Licensing, GP <br />Dept. 551, Volume Licensing <br />6100 Neil Road, Suite 210 <br />Reno, Nevada USA 89511-1137 <br /> <br />I Prepared By: Forrest Silverman <br /> <br />Volume Licensing Programs Signature Form <br />(North America)State and Local(English) September 3, 2007 <br /> <br />Page 2 of 2 <br />