System x Deal Registration Form
                                                      DRF-REG/020 (Effective Date January 23, 2012)
                                                     e-mail to: sysxdreg@ca.ibm.com
              To nominate this customer for the New Customer Bonus Incentive Program for System x and System Storage or the 
                                          BP Led Incentive Program, please copy ncbp@tradeonemkgt.com
                          IBM's decisions depend upon accurate, thorough data submissions by the Business Partner. 
                                            Changes to this data may lead to changes in IBM's decisions. 
                         All required fields must be completed in order for your Deal Registration Form to be processed.
                                                     This form is IBM Confidential when completed.
                                                                  * Denotes Required Field
             BRAND:                                                             System x                                                          *
             Is this an update to a previous submission?                                                                                          *
             Enter your previous System x Registration Number or date of                                                                          *
             last submission.
             Is this a request to re-register an opportunity?                         Yes         No                                              *
                If "Yes," provide your previous Deal Registration Number                                                                          *
             Is this opportunity in the Global Partner Portal (GPP)?                    Yes         No                                            *
                                                              End User Information
                                                                                                                                                  *
             Full End User Name or U.S. Federal Government Account 
             who is purchasing the equipment.  This name must match the 
             special bid.
                                                                                                                                                  *
                If U.S. Federal Government and if applicable, indicate the 
                Integrator or Contractor buying on behalf of the U.S. 
                Federal Government. 
             Company/Government Account URL                                                                                                       *
                                                                                      Commercial                                                  *
                                                                                      Business
             Classified:  If U.S. Federal Government, the next question is            State/Local Government/Education
             mandatory.                                                               U.S. Federal 
                                                                                      Government
                If the company is buying on behalf of the U.S. Federal 
                Government, identify the Federal Agency and program 
                name, if applicable.
             Address 1 (associated with the End User in Line 17)                                                                                  *
             Address 2
       City                                                             *
       State                                                            *
       Zip Code                                                         *
       Country                                                          *
       Will your firm sell the IBM System x footprint exclusively for   *
       this opportunity?
       (This question pertains to only the System x portion of this 
       opportunity.)
       Are you registering this End User as an ISR (Industry            *
       Solution Reseller) or IOEM (Indirect Original Equipment 
       Manufacturer)?                      Yes   No
       (The End User will remarket the System x product with their 
       solution.)
        If you answered YES to the previous question, please            *
        indicate which type of relationship.
         First contact name at End User's location (Required)
         Decision Maker's Name                                                                      *
         Decision Maker's Title                                                                     *
         Decision Maker's Phone                                                                     *
         Decision Maker's e-mail                                                                    *
         Second contact name at End User's location (Optional)
         Decision Maker's Name
         Decision Maker's Title
         Decision Maker's Phone
         Decision Maker's e-mail
                                      Business Partner Information
         Business Partner Legal Name                                                                *
           DBA Name
         Business Partner Contact Name                                                              *
         Business Partner Contact Phone                                                             *
         Business Partner Contact e-mail                                                            *
         Alternate Business Partner Contact Name                                                    *
         Alternate Business Partner Contact e-mail                                                  *
         Business Partner Location ID                                                               *
         Are you working with an IBM Representative?       Yes     No                               *
           If "Yes," list the IBMer's name                                                          *
                                          Distributor Information
             A single distributor must be named on each Deal Registration Form (DRF).  If approved, the named distributor will be defined under the 
           associated Deal Registration Number (DRN), and all rebate claims which include that DRN will be limited to only that named distributor.  Any 
         rebate claim made by a distributor that is not named on the DRF will be rejected.  If unique circumstances arise during the registration period that 
          require fulfillment through another distributor, contact your IBM Representative.  If a distributor is not named on the DRF, the submission will be 
          rejected by IBM.  Partners who are approved by IBM to submit their own rebate claims are exempt from the requirement to name a distributor on 
                                                   their DRF.
         Distributor Name                                                                           *
         Distributor Contact Name
         Distributor Contact e-mail
                                                         Opportunity Information
             Opportunity Name                                                                                                               *
             Detailed Opportunity Description including but not limited to:                                                                 *
              
             1. Describe the server-related business problem and 
                 the reason the End User is purchasing this solution. 
              
             2. What is the End User's current server strategy for 
                 this opportunity?  (List the efforts that have been 
                 made to support this strategy.) 
              
             3. Describe how this End User will implement this
                 System x solution. 
              
             4. Is this a new System x server or an upgrade?  
             Is this registration for a VMware ELA (Enterprise License                                                                      *
             Agreement)? If "Yes," the registration for the hardware must          Yes        No
             be submitted on a separate form.
             List the proposed hardware for this opportunity                                                                                *
             List the applications installing on the servers associated with                                                                *
             this opportunity
             End User Decision Date (mm/dd/yyyy)                                                                                            *
             End User Installation Date (mm/dd/yyyy)                                                                                        *
             Estimated list price of the opportunity (i.e., $50,001). Must be                                                               *
             over $50,000 to be registered
             What is the current Sales Stage?                               04-Validated/Qualifying                                         *
             Probability percentage of winning?                             25%                                                             *
                 If available, attach an Excel spreadsheet of the proposed configuration using the IBM SSCT or Blue Horizon 
                                                                  configuration tool.
             The configuration must include both part numbers and descriptions for all components of each server. Lists of part 
                                                            numbers are not acceptable.
                                                             Installation Address
             Name of Company/Department where the equipment will be                                                                         *
             installed
             Street                                                                                                                         *
             City                                                                                                                           *
             State                                                                                                                          *
             Are there multiple installation locations?                            Yes        No                                            *
               If "Yes," list all other installation locations. (Provide Street                                                             *
               Address, City and State as above)