Please use this form only if you want to change
DNS records for your domain but keep ACTIVE 24 as Registrar.
This form cannot be used to change DNS records for a .uk domain name
Note: This form must be sent
by fax, e-mail or posted to Active 24
*Only typed forms will be
processed
Fax, e-mail or send to:
Mamut Software Ltd, 90 Long Acre, Covent Garden, London WC2E 9RZ Fax: 020 7153 0901, E-mail: support@mamutactive24.co.uk
To modify(domain name): *
The
undersigned:Technical contact:
Contact
person (name)
*
Contact
person (name)
*
Organisation/company:
*
Organisation/company:
*
Organisation number:
Organisation number:
Address
line 1:
*
Address
line 1:
*
Addess
line 2:
Address
line 2:
Zipcode
and city:
*
Zipcode
and city:
*
State /
country:
*
State /
country:
*
E-mail
address:
*
E-mail
address:
*
Phone
number:
*
Phone
number:
*
Fax
number:
Fax
number:
Name server 1, Hostname: *IP address:...*
Name server 2, Hostname: *IP address:...*
Name server 3, Hostname: IP address:... Name server 4, Hostname: IP address:...
The undersigned hereby confirms that he or she is the
rightful owner of the domain name:*, and that he or she has the authority or legal rights to
request to request a redelegation.
Fields
marked with (*)
are mandatory.
Name:*Date and
signature:_________________________________*
Active 24 ASA shall not be liable to you or your business
for any incidental, consequential or special damage or lost or
imputed profits caused by time delays updating name
servers.