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Slide 1: Sage Nonprofit Solutions Virtual Services Administrative Requests Authorization Form (chargeable requests) The purpose of this form is to authorize Sage Software, Inc., (“Sage”) to process chargeable administrative requests for your Sage-hosted product. This authorization is intended to protect the security of your system. Please fill in the information below. Hosted Product: Serial #: Case Number: Restore database from backup. The organization database name is . Please specify the date and the time to which you want your data restored (i.e. how far back do you want to go?): Date: Time: Central Time Customer is allowed one (1) free local restoration event per calendar month and one (1) free offsite restoration event per calendar year. Charges for additional local restoration events will be assessed in 1-hour increments at a rate of $165/hr with a 1-hour minimum. Charges for additional offsite restoration event will be assessed in 1-hour increments at a rate of $165/hr with a 2-hour minimum. Request a current backup copy of the organization database. The backup copy will be sent electronically through a secure connection. The organization database name is . Customer is allowed one (1) free backup copy of the organization database per calendar month. Charges for additional backup copies will be assessed in 1-hour increments at a rate of $165/hr with a 1-hour minimum. Sage has estimated that the total time is applicable sales tax. Add user account(s) Last Name Smith First Name Adam User Logon Name Adam.Smith Email Address Adam.Smith@your.org Security Group(s) if applicable Accounting, Payroll Effective Date 10/31/2010 hour(s). The total charge for the services is $ , plus any There is a one-time setup fee per user ($120 for Sage MIP Fund Accounting and $75 for Sage Fundraising 50). In addition, your monthly hosting fees are based on the number of users; your monthly hosting fees will increase commensurate with the number of users you add. Disclaimer Before this request will be processed, I understand that a Sage Customer Support Analyst must first verify that I am an Administrator in the hosted application. This validates my authority to make this request. I understand that after restoring an organization database from backup, any data entry since the date and time specified above will be lost. It is my organization’s responsibility to re-enter any lost data. By signing this document, I authorize Sage to process the administrative requests on this form. Authorized Signature: _____________________________________ Date: _______________ Printed name: Title/Position: Sage Fax Number: 866-717-2711 Last updated: 9/2/2009, SPS/FC