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Domain Authorization Letter: City

[City Government Letterhead]

[Date]

.Gov Domain Registration
c/o Verisign, Inc.
12061 Bluemont Way
Reston, Virginia 20190

Dear Domain Manager,

As [Mayor (or equivalent title)] for the City/Town of [City/Town Name, State Name], I formally request that authority over the [xxxxx.gov] second-level domain name be delegated to the City/Town of [City/Town Name, State Name]. I attest that I am the highest-ranking elected official for [City/Town Name, State Name] or have signing rights on behalf of the [Title of the Highest-Ranking Elected Official] for the City/Town of [City/Town Name, State Name].

This domain name will be used for [state the purpose]. The use of this domain is consistent with the City/Town of [City/Town Name] Internet policy. In addition, I will ensure the content of the requested domain name conforms to the .gov policy.

By requesting this domain name, I acknowledge that I will be responsible for payment of the annual $400 domain fee. I understand that if I wish to retire my domain, I must submit a written request to registrar@dotgov.gov. If a written request is not submitted, I understand that I will continue to be responsible for all accrued domain fees.

The following individuals will be listed as points of contact for [xxxxx.gov]. It is understood that the contact information must remain valid and up to date, and that administrative, billing, and technical points of contact will be unique.

Administrative Point of Contact
First Name, Last Name
Title
Address
Phone Number
Email Address

Billing Point of Contact
First Name, Last Name
Title
Address
Phone Number
Email Address

Technical Point of Contact
First Name, Last Name
Title
Address
Phone Number
Email Address

Security Point of Contact [recommended, see https://home.dotgov.gov/management/security-best-practices/#add-a-security-contact] Email Address

Sincerely,
[Signature]

[Name]
[Title]