Windows Media Licensing (WMLA) Contact Change Request Form A –12-14-07
Date: ____________________
Microsoft Corporation
Attn: Windows Media Licensing
One Microsoft Way
Redmond, WA 98052
Re: Contact Change Request
Company Name: _____________________________________________________
License Title: ________________________________________________________
License Number: _____________________________________________________
Dear Windows Media Licensing:
I hereby inform you that we request our License Agreement contact information be updated
using the following information provided in this letter:
GENERAL NOTICES / SEND ORIGINALS TO
ADD or REPLACE or CONFIRM Company Primary License Agreement Contact*
(Please Select One):
Current/ Old Contact Name (if being replaced):
New Primary Contact Name:
Primary Contact Title:
Street Address:
City and State / Province:
Country and Postal Code:
Primary Contact Phone Number:
Primary Contact Fax Number:
Primary Contact Email:
*The Company Primary Contact (i.e. General Notices) will receive copies of ALL Communications related to this Agreement, including the execution copies, signed originals and technology releases and updates.
Windows Media Licensing (WMLA) Contact Change Request Form A –12-14-07
TECHNICAL CONTACT / SHIP TO CONTACT
ADD or REPLACE or CONFIRM Company Technical Contact/ “Ship To” Contact**
(Please Select One):
Current/ Old Contact Name (if being replaced):
Contact Name:
Contact Title:
Street Address:
City and State / Province:
Country and Postal Code:
Contact Phone Number:
Contact Fax Number:
Contact Email:
**The Company Technical Contact will receive all communications regarding technical issues. For
agreements that have Deliverables, the Company “Ship To” Contact will be the only contact granted
access to the Deliverables and will receive all communications regarding technical issues. If there is a
change in the “Ship to” contact WMLA will not rerelease deliverables to the new contact. The new
contact must request deliverables via [email protected].
BILLING CONTACT
REPLACE or CONFIRM Company Billing Contact***
(Please Select One):
Current/ Old Contact Name (if being replaced):
Contact Name:
Contact Title:
Street Address:
City and State / Province:
Country and Postal Code:
Contact Phone Number:
Contact Fax Number:
Contact Email:
***The Company Billing Contact will receive all communications regarding invoicing and collections.
Windows Media Licensing (WMLA) Contact Change Request Form A –12-14-07
FOR FINAL PRODUCT AGREEMENTS ONLY
ROYALTY REPORTER
ADD or REPLACE or CONFIRM Company Royalty Report Submitter****
(Please Select One):
Current/ Old Contact Name (if being replaced):
Contact Name:
Contact Title:
Street Address:
City and State / Province:
Country and Postal Code:
Contact Phone Number:
Contact Fax Number:
Contact Email:
****The Company Royalty Report Submitter will receive all communications regarding royalty reporting and should be the person that submits the annual royalty report and notifications to Microsoft as specified in the Agreement.
Thank you for your attention to this matter.
Sincerely,
____________________________________________________
By (Signature)
____________________________________________________
Name (Printed)
____________________________________________________
Title
____________________________________________________
____________________________________________________
Date