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Microsoft Corporation <br />Signature <br />Printed First and Last Name <br />Printed Title <br />Signature Date <br />(date Microsoft Affiliate countersigns) <br />Agreement Effective Date <br />(may be different than Microsoft's signature date) <br />Optional 2nd Customer signature or Outsourcer signature (if applicable) <br />Name of Entity (must be legal entity name)* <br />Signature* <br />Printed First and Last Name* <br />Printed Title <br />Signature Date* <br />* indicates required field <br />Name of Entity (must be legal entity name)* <br />Signature* <br />Printed First and Last Name* <br />Printed Title <br />Signature Date* <br />* indicates required field <br />If Customer requires physical media, additional contacts, or is reporting multiple previous Enrollments, <br />include the appropriate form(s) with this signature form. <br />After this signature form is signed by the Customer, send it and the Contract Documents to <br />Customer's channel partner or Microsoft account manager, who must submit them to the following <br />address. When the signature form is fully executed by Microsoft, Customer will receive a confirmation <br />copy. <br />Microsoft Corporation <br />Dept. 551, Volume Licensing <br />6100 Neil Road, Suite 210 <br />Reno, Nevada 89511-1137 <br />USA <br />Program3lgnForm(MSSign)(NA,LatAm)EXBRA, MLI(ENG)(Aug2014) Page 2 of 2 <br />P112 <br />