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					                                                                                    1B, South Sea Mansion, 81 Chatham Road South,
                                    Domain Name Registration                        Tsimshatsui, Kowloon, Hong Kong.
                                                                                    Phone : 2376 2371
                                          and Hosting                               Fax      : 2375 1333
                                                                                    Dial-up : 3001 8200
                                                                                    E-mail : info@iohk.com
                                            DOMAIN REGISTRANT INFORMATION
    Organization Name ______________________________________________________________________________
    Address _______________________________________________________________________________________
    _________________________________ City ________________________ Country _________________________
    Contact Person (Last, First) ____________________________________________________________(Mr/Mrs/Ms) +
    Phone _____________________ Fax _____________________ E-Mail Address ____________________________
    Required Service     Create New Domain      First Choice ______________________________________________
                                                Second Choice____________________________________________
                         Modify Domain          Original Domain __________________________________________
                                                New Domain _____________________________________________
                         Delete Domain          Domain _________________________________________________
                         Host Existing Domain   Domain _________________________________________________
                                               CONTACT PERSON INFORMATION
    Administrative Contact
    Name (Last, First) __________________________________________________________________(Mr/Mrs/Ms) +
    Organization Name ______________________________________________________________________________
    Street Address __________________________________________________________________________________
    City _____________________ Country ______________________ Phone Number ___________________________
    Fax Number ___________________________ E-Mail Address ___________________________________________
    Billing Contact
    Name (Last, First) __________________________________________________________________(Mr/Mrs/Ms) +
    Organization Name ______________________________________________________________________________
    Street Address __________________________________________________________________________________
    City _____________________ Country ______________________ Phone Number ___________________________
    Fax Number ___________________________ E-Mail Address ___________________________________________
                                                     PAYMENT INFORMATION
    Services Charges:
     First Time Registration Fee
          International (*.com)           HK$1200 (including hosting fee for first 2 years)
          Local (*.com.hk)                HK$500 (including hosting fee for first year)
     Yearly Hosting Fee
          International (*.com)           HK$600
          Local (*.com.hk)                HK$300 (not including registration renewal fees for HKDNR)
    Payment Method (Please “” one)
     By Cash
     By Cheque
       Cheque No. _______________________________________________

         Bank Name _______________________________________________


                                                                    NOTE
    1.   It normally takes one week for a registration.
    2.   For registration of local domain name (*.com.hk), please attach a copy of your Business/Branch Registration Certificate for
         administrative purpose.
    3. All fees paid are non-refundable.
                                                              DECLARATION
    I confirm that all the above information given is true and correct.

                                                                                                Date:
    Signature:

                                                    FOR OFFICIAL USE ONLY


    Person in Charge ____________________________________________________________ Date: ________________________
+
    delete as appropriate                                                                                           FORM DR 0108

				
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