If you were the registrant
for a domain name that you
feel was transferred away
from our registrar without
your approval, please fill
out the information below.
In order for us to assist
you in your claim, all of
the following information
must be provided. Please
send the following form
along with the required
documents to
support@411WebHost.com
or fax to 866-459-1909.
Once we verify the
information below we will
contact the current
registrar to attempt to
resolve the problem.
Domain Information:
Domain Name:
_________________________________________________________________
Registrant’s First
Name at the time of the
Transfer:
__________________________________
Registrant’s Last
Name at the time of the
Transfer:
__________________________________
Company Name at the
time of the Transfer:
________________________________________
I have attached a copy of
the registrant’s government
issued photo identification
to this form. (Please
lighten the photo ID before
faxing). If the person
signing the request is not
the registrant, please
submit an ID for both the
registrant and the
requestor.
Attach Photo
ID Here
* A photo ID is a
copy of a
State Issued
Driver's License
or a
Passport with a
photo. |
If a company is listed under
Registrant, I have attached
a government issued photo
identification of the person
signing below and have
attached one of the
following documents for
company identification
(company name must match
exactly).
-
A copy of business
license
-
Tax certificate (number
alone is not acceptable)
-
“Doing Business As”
documentation
-
Fictitious Name
Documentation
-
IRS 501(C)3
“Determination Letter”
-
State issued certificate
of tax exemption showing
charitable status
Attach
Company Documents
Here
* Attach larger
documents or
multiple page
documents to the end
of this form. |
Daytime Phone Number (in
case we have questions):
Valid Email Address:
A valid email
address must be provided for
Domain Services to respond.
The email address given must
not be associated with the
domain(s) the dispute is
requested on.
I am requesting that Domain
Services verify registrant
information and contact the
current Registrar to attempt
to transfer the domain name
back to my account. I
certify and affirm that I am
the registrant listed above,
or, if not the registrant, I
am the authorized requestor
of the registrant. I agree
that neither Registrar nor
any of its affiliates shall
be liable to me or any other
party in any amount for any
actions taken pursuant to
this request. I hereby
waive and release any and
all claims related to this
request asserted against
Registrar or any of its
affiliates. Additionally, I
agree to defend, indemnify,
and hold harmless Registrar
and its affiliates for any
loss, liability, damages,
costs or expenses (including
reasonable attorneys' fees)
resulting from any
third-party claim, action or
demand related to this
request, this authorization,
or any actions taken by
Registrar in connection
therewith.
If the government issued
photo or
company identification you
have supplied is found to
have been altered or is not
a valid form of ID, you
understand and agree that we
may, at our discretion,
share this information with
other registrars or law
enforcement.
Signed Name:
Date:
(Registrant or Authorized
Requestor’s Signature)
Printed Name:
If you have
any questions about our
policy, please contact us
at:
411WebHost
Gallium
Optronics, LLC
ATTN: Web Team
3350 Riverwood Parkway
Suite 1900
Atlanta, GA, 30339, U.S.A.
|