Contact Information Update Form

Main ETAP Contact: Main ETAP Contact will receive all software upgrades and renewal notices
Name: Jigyesh Sharma Title: Assistant Manger Engineering
Company: Larsen & Toubro - Control & Automation Division
Address: A-600 TTC Industrial Area, Shil-mahape Road, Navi Mumbai
City: Navi Mumbai State: Maharastra Zip: 400710 Country: India
Phone: 022-67229740 Mobile: +91-9769632854 Email: Jigyesh.sharma@lntebg.com

Procurement / Billing Contact: ✔ Same Address as Main ETAP Contact (please fill out contact name, title, email, tel, fax)
Name: Title:
Company:
Address:
City: State: Zip: Country:
Phone: Mobile: Email:

IT Contact: ✔ Same Address as Main ETAP Contact (please fill out contact name, title, email, tel, fax)
Name: Title:
Company:
Address:
City: State: Zip: Country:
Phone: Mobile: Email:

Technical / Engineering Contact 1: ✔ Same Address as Main ETAP Contact (please fill out contact name, title, email, tel, fax)
Name: Title:
Company:
Address:
City: State: Zip: Country:
Phone: Mobile: Email:

Technical / Engineering Contact 2: ✔ Same Address as Main ETAP Contact (please fill out contact name, title, email, tel, fax)
Name: Title:
Company:
Address:
City: State: Zip: Country:
Phone: Mobile: Email:

Please return to sales@etap.com or this can be faxed to (949) 462-0200.

This Contact Information Update Form is confidential and proprietary to ETAP/Operation Technology, Inc. and may not be reproduced, published or disclosed to others
without the written authorization of ETAP/Operation Technology, Inc., 17 Goodyear, Suite 100, Irvine, CA 92618, USA. © 2012 by ETAP/Operation Technology, Inc.
All Rights Reserved.