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By signing below, the Reseller identified above confirms that all information provided in this <br />Enrollment is correct. <br />Signature* <br />Printed name* <br />Printed title* <br />Date* <br />x indicates required fields <br />Changing a Reseller. If Microsoft or the Reseller chooses to discontinue doing business with <br />each other, Enrolled Affiliate must choose a replacement Reseller. If Enrolled Affiliate or the <br />Reseller intends to terminate their relationship, the initiating party must notify Microsoft and the <br />other party using a form provided by Microsoft at least 90 days prior to the date on which the <br />change is to take effect. <br />e. If Enrolled Affiliate requires a separate contact for any of the following, attach the Supplemental <br />Contact Information form. Otherwise, the notices contact and Online Administrator remains <br />the default. <br />EA2016EnrGov(US)SLG(ENG)(Nov2016) Page 10 of 10 <br />Document X20-10634 <br />