Personal info
first_name:
last_name:
org_name:
address1:
address2:
address3:
city:
state:
postal_code:
country:
phone:
fax:
email:
url:
lang_pref:
Domain info
registrant_ip:
affiliate_id:
Recorded on renewal order Leave blank for no affiliate
reg_username:
reg_password:
reg_domain:
custom_tech_contact:
handle:
domain_list:
coma separated no spaces