GITN
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|GITN |Domain Name Service Form |Page 1 of 3 (DNS1) |
|SDN BHD | | |
| | |Revision : 3.0 |
| | |Date Issued : 20.09.2007 |
|Filled By Applicant |For GITN Used |
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|1. |Ticket No : |
|Domain Name | |
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|. gov . my | |
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| |Date Register |
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|Others | |
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|Example |Register or modify At : |
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|.my / .my |dns1..my |
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|2. | |
|Type Of Application | |
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| |dns2..my |
|New Domain Registration | |
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|*Fill Form DNS03 & DNS 02 for Details | |
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|Domain Modification | |
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|*Fill Form DNS02 only | |
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| |Received By: |
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| |Name |
|Remarks : |: |
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| |Email |
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| |Phone |
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| |Implement By: |
|3. | |
|Requestor | |
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| |Name |
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|Name |Email |
|: |: |
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| |Phone |
|Agency |: |
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|Email | |
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| |Date Received |
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|Phone ( off / hp) | |
|: |Task Begin |
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|/ | |
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|Signature or | |
|Stamp Pad | |
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|Date Request | |
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|Expected Deliverable | |
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|(dd/mm/yy) | |
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|*The applicant is responsible for the accuracy of the information contained in this form. | |
|GITN – Received By |GITN Verification |: |Approved / Not Approved |
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|Name |: | |Name |: | |
|Signature |: | |Signature |: | |
|Date |: | |Date |: | |
| |DNS Configuration Form | |
|GITN | |Page 2 0f 3 ( DNS1) |
|SDN BHD | | |
| | |Revision : 3.0 |
| | |Date Issued : 20.09.2007 |
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|Filled By Applicant |For GITN Used |
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|Changes Mode |Public IP |
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|HostName | |
|Domain Names | |
|Type Of Server | |
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|mail server |Remarks |
|web server | |
|apps server | |
|Publish At | |
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|Internet | |
|Intranet | |
|Both | |
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|Hosting At | |
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|Public DNS GITN | |
|Private DNS GITN | |
|Non Private DNS GITN | |
|Non Public DNS GITN | |
|*for non DNS GITN,please provide IP DNS | |
|IP Address | |
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|[pic] | |
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|[pic] | |
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|[pic] | |
| |Name |
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| |Date |
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|Filled by requestor |Email |
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|[pic] | |
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| |* Gived a copy to a requestor |
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|[pic] | |
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|[pic] | |
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|[pic] | |
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|[pic] | |
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|Remarks: | |
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|* Only 5 entries per page | |
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|GITN |Domain Name Service Form |Page 3 of 3 (DNS1) |
|SDN BHD |New Registration | |
| | |Revision : 3.0 |
| | |Date Issued : 20.09.2007 |
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|1. |
|Type Of Registration |
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|New Domain Registration |
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|Modify Domain |
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|2. |
|Domain Name |
|: |
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|Example |
|: |
|.my/.my |
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|3. |
|Registrant Details |
|(Fill up by Requestor) |
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|Registrant Must have a local presence in Malaysia |
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|3a. |
|Organisation Name |
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|3b. |
|Organisation Registration No |
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|3c. |
|Organisation Address |
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|3d. |
|Organisation Phone Number |
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|3e. |
|Organisation Fax Number |
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|4. |
|Administrative Contact |
|(Fill up by Requestor) |
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|The Administrative Contact must be an authorised employee of the Registrant |
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|4a. |
|Name |
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|4b. |
|Phone Number |
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|4c. |
|Fax Number |
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|4d |
|Email Address |
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|Important : |
|This page is only for new registration and modification domain in MYNIC. |
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