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Any notices must be addressed to the contact and Iocations outlined below. We will notify you in writing
if our address information changes. You must notify us in writing if your address changes.
Customer Information
Notices Information
Microsoft Information
Company Name
Name and address of contracting Microsoft
affiliate
MSLI, LLC
6100 Neil Road
Suite 210
Reno, NV
USA 89511-1137
Phone Number - 775-823-5600
Fax Number - 775-826-7287
Street Address and/or Post Office Box
City and State / Province
Country and Postal Code
Contact Name
Phone Number
Fax Number
Internet Address
All NOTICES should have Copy To:
Microsoft Corporation
Law and Corporate Affairs
One Microsoft Way
Redmond, Washington USA 98052
Attention: Select Attorney
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Shipping Information
License Confirmations and Select CD-ROMs will be shipped to the following address. If CD-ROM ship
address differs from the License Confirmation ship address, please complete the Welcome Kit/CD-ROM
shipment address section on the following page.
License Confirmation Information Microsoft Contact Information
(If different from Notices contact)
Customer Name
Microsoft Account Manager Name
Street Address
Microsoft Subsidiary Location
City and State / Province
Country and Postal Code
Contact Name
Phone Number
Fax Number
Internet Address
Language (If different than language of this
agreement)
Microsoft Contact Email Address (if
applicable)
Microsoft will automatically ship ONE SELECT CD-ROM subscription with a Welcome Kit for
each pool and language designated in the table below. If your right to purchase licenses under a
particular pool has been terminated (for failure to comply with your forecast), Microsoft will
discontinue shipment of subscriptions for that pool. Please mark each box with an "X" for the
language(s) you wish to have shipped for each of the pools you have chosen on the cover page. If
you would like to receive additional shipments of CD-ROM subscriptions you may order them
through your Large Account Reseller for a fee.
Language
Application Pool
System Pool
Server Pool
Arabic
Basque
Brazilian
Catalan
Chinese -Simplified
Chinese -Traditional
Czech
Danish
Dutch
East European
English
Finnish
French
French Canadian
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German
Greek
Hebrew
Hungarian
International English
Italian
Japanese
Korean
Norwegian
Polish
Portuguese
Russian
Spanish
Swedish
Thai
Turkish
Welcome Kit / CD-ROM Shipment Contact
(if different from License Confirmation contact
Company Name
Contact Name
Street Address
Phone Number
City and State / Province
Fax Number
Country and Postal Code
Internet Address
Existing/Prior Select Master Agreement(s): Please indicate the agreement
no(s). of your prior or existing Microsoft Select Master Agreement(s), if
any. Please note, your existing agreement(s) will not be automatically
terminated. If you wish to terminate an existing agreement, please contact
your Microsoft account manager or reseller.
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Agreement
No(s).:
Affiliate Participation Form
(The following information must be completed by the customer and updated, as necessary, by written
notice to the contracting Microsoft affiliate)
List the affiliates which will sublicense products from you or another enrolled affiliate under this
agreement, rather than executing their own enrollment. The entities must be grouped by country. Attach
additional sheet(s) if necessary. Affiliates not listed below will not be licensed under this agreement.
Listing an affiliate on this form does not preclude that affiliate from signing its own enrollment.
Names of affiliates not becoming enrolled affiliates, but receiving
products by sublicensing from you
Name of Country
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Reseller Information Form
You must choose a Large Account Reseller authorized in your area. If, at any time during the
term of the agreement, you wish to terminate the relationship with your designated Large Account
Reseller, or if we discontinue the reseller's status as Large Account Reseller, you must choose a
replacement. If you intend to change Large Account Resellers, you must notify us and the old
Large Account Reseller in writing of the new Large Account Reseller you have designated. To
avoid purchasing delays such a change might entail, you should provide us with 30 days prior
written notice.
(The following sections should be completed by the Large Account Reseller)
Large Account Reseller Headquarter Information Large Account Distributor Information (if applicable
Reseller Name
Distributor Name
Headquarters Street Address and/or Post Office
Box
Headquarters Street Address and/or Post Office
Box
City and State / Province
City and State / Province
Country and Postal Code
Country and Postal Code
Contact Name
Contact Name
Phone Number
Phone Number
Fax Number
Fax Number
Internet Address
Internet Address
The undersigned confirms that the Large Account Reseller and Large Account Distributor
information is correct.
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Name of Large Account Reseller: Name of Large Account Distributor (if
applicable):
By: By:
(signature) (signature)
Name: Name
(printed) (printed)
Title: Title:
(printed) (printed)
Date: Date:
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