CSS License Transfer

							                                           Classification



                                        License Transfer Form

Requestor Work Order #                                                         CSS Work Order #

Organization Transferring Licenses to CSS
 Requestor                                                  Contractor
 Phone                                                      Location
 Bldg / Mailstop                                            Project

Location of license
 Processing system                                              Location (if different from above)
 Hostname                                                       System ID / hostID
 Operating System            Linux              Solaris               Windows
                             AIX                IRIX                  OpenVMS       Other

Product Description
 Vendor (Manufacturer)
 Product                                                                                                    Version
 Quantity                                                                                                   License #
 License Type                              Floating / Concurrent                 Nodelocked                    Individual / Named User
 (Access control)                          Dongle          N/A                Other:
 License Type                              Server               Client             Development                 Runtime
 (Usage) if specified by Vendor

Vendor Maintenance
 Is product currently under vendor support                Yes                 No                Expired             Don’t know
 Period of performance                               From                            to
 Seller of support contract if different from
 manufacturer (Is it from a reseller?)
 Vendor Contact for last maintenance                 Name                                               Phone
 renewal
 Customer number, Customer ID, support
 agreement number, etc
 Most recent purchase order                          Placed by (company)
 If possible, provide copy with company              Date                                 PO Number
 proprietary information deleted.

    Is product on the APL or NES Baseline?                  Yes          No    If No, please explain: See Comments Below

 Comments:




                    When the form is completed, please return it to the CSS Inbox, fax it to 303-677-3833, or email it to
                                dvc-css-requests@adf.npa.gov (secure) or css@dvsis.com (unsecure).

Revised 12/11/05
                                        Classification