To submit this form, send the completed document to the provided email addresses, ensuring all required fields are filled in and signatures are included. Email completed form to billing@example.com, cc accountmanager@example.com. You may also fax it to (123) 456-7890 or mail it to Google LLC, 1600 Amphitheatre Parkway, Mountain View, California 94043. Ensure all details are correct to avoid delays.

This form's initial term starts on the Effective Date and continues for 12 months unless terminated earlier. The form renews according to Agreement terms.

The purpose of this form is to facilitate the process for customer affiliates to access Google Cloud Platform services. It collects essential information including corporate contact details, billing account management, and specific order information. Completing this form ensures a smooth onboarding and access to required technical support services from Google Cloud.

• 1. Customer Affiliate Information: Section to enter the affiliate's full legal name, existing customer's full legal name, and corporate contact information.
• 2. Billing Contact Information: Enter details of the contact who will review the invoice, including name, address, phone, and email.
• 3. Billing Account Information: Details about the billing account administrator, email, purchase order requirements, tax exemptions, and customer domain.
• 4. Order Information: Specify product details, technical support services ordered, and other terms if any.
• 5. Account Manager Section: Section for the account manager to complete required details such as Google Legal Customer ID.
• 6. Signatures: Authorized representatives from both Google and the Customer Affiliate must sign and date the form.

Failure to submit this form may result in delayed access to Google Cloud Platform services.

• Delayed Service Access: Not submitting the form could prevent timely access to services.
• Billing Issues: Incomplete billing information can result in invoicing errors.
• Account Management Problems: Failure to submit may affect user role management on the billing account.

• 1. Customer Affiliates: Required for affiliates to access cloud services.
• 2. Billing Account Management: Needed to provide billing account details and manage roles.
• 3. Technical Support Services: Use this form to request specific technical support services.
• 4. Corporate Contact Information: Collect corporate contact details for communication and billing purposes.
• 5. Order Processing: Required by Google Account Managers to process orders for affiliates.