Domain Renewal Application


Current Domain Information

1.        Domain Name(s) to Renew:        Þ

Please spell exactly as registered.
Use separate applications for each
domain if different registrants.

2. Current Registrant Name or Organization:


3. Signature of Domain Registrant or Authorized Representative:


X                                                                                 Date:

4. Enter a new secret domain password:

(Use word or phrase. Letters, numbers, and symbols are permitted. Password will be required to make future modifications to the domain record)




If We Need to Contact You

5. Your Name:

6. Telephone:

7. Your Email Address:

8. Notes or Comments: (optional)



Renewal and Payment Information

9. Number of Year to Renew
 (check desired renewal plan):

Domain anniversary date will be extended from the current anniversary by the additional years you indicate.. Prices for .com/net/org/info/biz/us. For .cc add $25 for each year.

~~~~~~~~~  Limited Time – Special Pricing ~~~~~~~~~

ÿ 1-year                  ÿ 2-years               ÿ 5-years               ÿ 9-years

$ 35 $ 15                  $ 70 $ 25                $ 175 $75               $ 315 $ 115

(Prices per domain, US dollars)
Late Fee, if applicable (expired domain)         $10 

ÿ Redemption Fee (expired/deleted domain)     $80


10. Credit Card Type:         ÿ Visa/Master       ÿ Amex                  ÿ Discover            ÿ Diners

11. Credit Card Number:
(or remit with check made to “Domain Registration Services)


12. Card Expiration Date (mm/yy):

13. Cardholder Name:



14. Cardholder Tel Number:

15.     Exact Card Billing Address:



16. Cardholder Signature:  X                                                                                              Date:




Return By Fax:   +1 215 922-4961    (no cover sheet needed)


Mail to:                        Domain Registration Services
                                      P.O. Box 447
                                      Palmyra NJ 08065 USA
                                      Attention: Renewals


Return by fax or regular mail. 




Retain a copy of completed form for your records.

Domain renewal is subject to the terms and conditions on the following page.



Terms and Conditions


The purpose of the Domain Renewal Form is to add years to the existing domain name.  In renewal will involve changing the domain’s registrar of record to Domain Registration Services “DRS” (


1.                    In submitting this form, you represent and warrant that:

(a)      You are the authorized holder or representative of the subject domain name;

(b)      The individual authorizing this request represents and warrants that he/she is authorized to request a change of registrars and to apply for our registrar services;

(c)      The information you provide herein is accurate and complete;

(d)      You are not in default on any obligations you may owe to the current registrar;

(e)      You are not party to any dispute resolution  proceeding concerning your use or registration of the domain name;

(f)      The domain name is not the subject of any collection proceedings, including garnishment, attachment, levy;

(g)      We will not be responsible for any fees or obligations which you may owed by any third party;

(h)     You agree to release, indemnify, and hold us and our contractors, agents, employees, officers, directors and affiliates harmless from all liabilities, claims and expenses, including attorneys fees, of third parties arising under this Agreement.

(i)       By using our registrar service, you acknowledge that you have read and agree to be bound by all of the terms and conditions of this Agreement and any pertinent rules or policies that are or may be published by DRS.  You agree to abide by our Service Agreement available at:  and       


2.                    This Registrar Change Form constitutes the entire agreement between you and DRS concerning the subject matter hereof and supersedes any prior agreements, representations, statements, negotiations, understandings, oral or written, with respect to the subject matter expressly set forth herein.

3.                    This Registrar Change Form shall be governed by and construed in accordance with the laws of the United States of America and the Commonwealth of Pennsylvania. You agree that the exclusive jurisdiction and venue shall be in the United States District Court for the Eastern District of Pennsylvania, or if there is no jurisdiction in such court, then in a state court in Philadelphia County, Pennsylvania.

4.                    Domain renewal fees cannot be refunded in full or in part after renewal is completed.

5.                    If the subject domain has already expired or if it is available for new registration we will attempt to register the domain for you for the same price and number of years as requested in the renewal application.



You can make changes to administrative, technical and billing contact may be made online after renewal is completed.  Domain record modifications can be made at  (click “modify existing domain” at bottom of the page).