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Optional 2"d Customer signature or Outsourcer signature (if applicable) <br />Name of Entity (must be legal entity name)* <br />Signature* <br />Printed First and Last Name* <br />Printed Title* <br />Signature Date* <br />Name of Entity (must be legal entity name)* <br />Signature` <br />Painted First and Last Name* <br />Printed Title* <br />Signature Date* <br />indicates required field <br />If Customer requires physical media, additional contacts, or is reporting multiple previous Enrollments, <br />include the appropriate form(s) with this signature form. <br />After this signature form is signed by the Customer, send it and the Contract Documents to Customer's <br />channel partner or Microsoft account manager, who must submit them to the following address. When <br />the signature form is fully executed by Microsoft, Customer will receive a confirmation copy. <br />Microsoft Licensing, GP <br />Dept. 551, Volume Licensing <br />6100 Neil Road, Suite 210 <br />Reno, Nevada 89511-1137 <br />USA <br />Program Sign Form (MSSig n) (NA, LatAm)ExB RA, MLI (ENG)(OcI2012) <br />Page 2 of 3 <br />