End User Certificate Uk by dtw18678


End User Certificate Uk document sample

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									QuoVadis 30 Day Trial End-user
Certificate Request Form


 Type of Certificate Requested                          Trial 30 Day End-User Certificate

Applicant/Certificate Holder Details (this information will be included in the Certificate)
 First Name(s)
 Last Name
 e-Mail Address
 Title (e.g. Mr./Dr./Mrs.)1
1) Optional Certificate Entry

Additional Details required by QuoVadis (this information will not be included in the Certificate)
 Office Address (Street, City/Parish, Post Code,

 Direct Phone Number
 Mobile Phone Number
 Middle Name. If you don’t have one please
 state year of birth. (Answer used for
 online ID of applicant.)

Company Information
 Registered Company Address           (Street,
 City/Parish, Post Code, Country)

 Switchboard Phone (Business)
 Company Registration Number (Or equivalent
 Industry Registration Number, e.g. FSA Registration)

All data will be handled and stored as highly confidential according to the requirements of relevant Data Protection

By accepting this certificate I confirm that:
• all declarations made in relation to the information contained in the certificate are true and accurate
• reasonable measures will be taken to maintain sole control of, keep confidential, and properly protect at all times
   the Private Key that corresponds to the Public Key to be included in the requested Certificate
• the certificate will be used strictly in compliance with the QuoVadis certificate policy (CP/CPS) and Certificate Holder
• the certificate will immediately be declared invalid if the certificate details are no longer correct or the private key is
   lost, stolen, or potentially compromised
• I agree with the publication of the certificate
• I accept the QuoVadis Certificate Holder Agreement and “General Conditions for use of QuoVadis Certificates” below

The passphrase is chosen by the certificate holder during the certificate application. This helps QuoVadis to identify the
certificate holder. The passphrase will be used exclusively for this purpose.

Additional Information
The QuoVadis website (www.quovadisglobal.co.uk) provides additional information and documents relating to users’
rights and obligations, including:
- QuoVadis Certification Policy CP/CPS
- QuoVadis Relying Party Agreement
- QuoVadis Certificate Holder Agreement

Further Assistance & Support
https://support.quovadisglobal.com or email uk.support@quovadisglobal.com

 Date                                                   Signature of Applicant

                                                     QuoVadis Online Security Ltd
                                    7 Hayters Court, Grigg Lane, Brockenhurst, Hampshire, SO42 7PG
                                                        Tel +44 (0) 1508 530 616

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