RIPE NCC

Doc-ID: RIPE-317
Date: 26 April 2004 


% Provider Independent (PI) Assignment Request Form

#[GENERAL INFORMATION]#
request-type: pi-ipv4
form-version: 1.1
x-ncc-regid: 

#[ADDRESS SPACE USER]#
%
% Who will use the address space being requested?
legal-organisation-name:      
organisation-location: 
website-if-available: 

%
% Does the organisation already have address space that 
% can meet the needs for this request? Enter "Yes" or "No".
space-available: 

#[INITIAL INFORMATION]#
%
% Please read the following information and answer the 
% questions.
%
% 1. Why is PI space required rather than PA space?
%
why-pi:

%
% 2. Please check that you are not requesting extra address 
% space for routing or administrative reasons. See Section 
% 6.0 "Policies and Guidelines for Assignments" of the RIPE document "IPv4 
% Address Allocation and Assignment Policies in the RIPE NCC 
% Service Region".
%
routing-reasons:

%
% Please confirm whether you have made the End User aware 
% of the warning given in the RIPE document "Provider 
% Independent vs Provider Aggregatable Address Space", 
% Section 3, "Detailed Recommendations".
%
confirmation:

%
% You are required to confirm that the points mentioned 
% above have been read and understood and that the 
% organisation requesting the PI address space is fully 
% aware of the disadvantages of PI address space. 
%

#[ADDRESSING PLAN]#
number-of-subnets: 
address-space-returned: 

%    
%       Size
%       in CIDR    Immediate   1yr    2yr       Purpose
subnet:
totals:

#[EQUIPMENT DESCRIPTION]#
%
% Please describe the equipment that will be used in the 
% network. Indicate the function of the equipment and provide 
% information regarding the way it uses IP address space.
equipment-name:
manufacturer-name:
model-number:
other-data:


#[NETWORK DESCRIPTION]#
%
% If your description does not allow the Hostmaster to 
% understand the request you may be asked additional 
% questions. Please add any additional information that you 
% think may facilitate the evaluation of this request below.


#[NETWORK DIAGRAM]#
%
% Please enter "Yes" or "No" if you have attached a network 
% diagram in JPEG or PostScript format to this e-mail 
% request. 
diagram-attached:

#[DATABASE TEMPLATE(S)]# 
%
% Please include database template(s) here so that the 
% Hostmaster can register the assignment in the RIPE 
% Database. If it is necessary to create a maintainer object 
% please include that template too. 

inetnum:        
netname:       *specify a netname here* 
descr:         *specify the name of the organisation*
country:       *specify the country code*
org:             *specify org ID here*
admin-c:       *insert nic-handle of administrative contact*
tech-c:        *insert nic-handle of technical contact*
status:        ASSIGNED PI
mnt-by:        *specify mntner name here*
mnt-by:        RIPE-NCC-HM-PI-MNT
mnt-lower:     RIPE-NCC-HM-PI-MNT
mnt-routes:    *specify mntner name here*
mnt-domains:  *specify mntner name here*
changed:       hostmaster@ripe.net
source:        RIPE


#[END of REQUEST]#