I, the undersigned, hereby authorize Gigabit Business Consulting LLC to use these credentials on my behalf, as necessary, to complete help desk tickets and/or
business consulting and technology project work.

Website / URL / Description:   

Company Name:   

Username:           

Password:             

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Change fonts

• Draw Signature
  
• Type In Signature
  

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

Insert Signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Signature Certificate

Document name: Secure Credential Submission

Unique Document ID: 1b5a03c1bb1e54c65b45161e70e7233bcc5b184c

Build. Track. Sign Contracts.

Timestamp	Audit
January 3, 2020 5:01 pm MDT	Secure Credential Submission Uploaded by Joshua Barneck Barneck - joshua@gigabit.com IP 38.2.58.217

This audit trail report provides a detailed record of the online activity and events recorded for this document.

https://gigabit.com/

Audit Trail Serial# d3e1dcc43928309d9ca01ef7b7813129