******************** Please DO NOT REMOVE Version Number *********

Domain Version Number: 1.5

**************** Please see detailed instructions *****************

******** Only for registrations under the top level of .IO ********

Authorization
0. (N)ew (M)odify (D)elete: 
0c. User ID: 
0d. Password: 
0e. Account: 

1.  Purpose/Description: <256 characters>

2.  Complete Domain Name: <64 characters including .io>


Organization Using Domain Name
3a. Organization Name: <78 characters>
3b. Street Address: <78 characters>
3c. Town/City: <78 characters>
3d. State: <78 characters> 
3e. Post code: <38 characters>
3f. Country: <38 characters>

Administrative Contact

4a. Account ID: <18>

or

4b. (I)ndividual or (R)ole: <78>
4c. Name (Last , first): <78>
4d. Organization Name: <78>
4e. Street Address: <78>
4f. Town/City: <78>
4g. State: <78>
4h. Postcode: <38>
4i. Country: <38>
4j. Phone Number: <38>
4k. Fax Number: <38>
4l. E-Mailbox: <50>
4m. Password: <18>


Technical Contact

5a. Account ID: <18>

or

5b. (I)ndividual or (R)ole: <78>
5c. Name (Last , first): <78>
5d. Organization Name: <78>
5e. Street Address: <78>
5f. Town/City: <78>
5g. State: <78>
5h. Postcode: <38>
5i. Country: <38>
5j. Phone Number: <38>
5k. Fax Number: <38>
5l. E-Mailbox: <50>
5m. Password: <18>


Billing Contact

6a. Account ID: <18>

or

6b. (I)ndividual or (R)ole: <78>
6c. Name (Last , first): <78>
6d. Organization Name: <78>
6f. Town/City: <78>
6g. State: <78>
6h. Postcode: <38>
6i. Country: <38>
6j. Phone Number: <38>
6k. Fax Number: <38>
6l. E-Mailbox: <50>
6m. Password: <18>

Primary Name Server
ns1b. Primary Server Hostname: 
ns1c. Primary Server Net Address: 

Secondary Name Server
ns2b. Secondary Server Hostname: 
ns2c. Secondary Server Net Address: 

Optional Name Server
ns3b. Optional Server Hostname: 
ns3c. Optional Server Net Address: