The Cisco Technology Migration Plan
Certificate of Replacement Form
(For worldwide use)

Date:                             ______________
Customer Name:        _______________________________
Customer Address:   _______________________________

(1) The Software my company is trading in was validly licensed by my company directly or indirectly from the owner of the software.

(2) My company has replaced Software as detailed on:

Purchase Order No: __________________
RMA No:                    __________________
CTMP Quote No:     ___________________

Serial No’s: _________________________________________

3) To the best of my knowledge, my company has destroyed, and will no longer use, any of the software referenced above, as well as any documentation provided for my company’s use of that program.

Customer Signature: _____________________
Printed name:             _____________________
Title:                             _____________________
Phone Number:          _____________________

Required if Sold by Channel Partner:

I, the undersigned do act as Witness that the said Software, detailed on the Purchase Order above, has been replaced by Cisco product(s), and as the Channel Partner do recognize that should it be proven that the product has NOT been replaced, my company will, upon Cisco’s request, immediately repay the full amount of the trade-in credit I received. I further acknowledge that my company’s failure to follow the rules of this program may disqualify my company from this or other Cisco programs in the future.

Channel Partner Signature: _____________________
Printed name:                        _____________________
Phone number:                      _____________________

Required Cisco Representative (Account Manager, Channel Account Manager, or Sales Engineer)

I, the undersigned, as a representative of Cisco Systems do act as Witness that the product has been replaced.

Cisco Representative Signature:  _____________________
Printed name:                                 _____________________
Phone number:                               _____________________

Fax completed form to the Asset Recovery team at +31 (0) 168 359 411 for countries in EMEA and 408-608-0370 for the Rest of World.

All contents copyright © 1992--2003 Cisco Systems Inc. Important Notices and Privacy Statement.
Copyright © Cisco Systems Inc. 2003