Provider Independent (PI) Assignment Request Form

RIPE NCC

Doc-ID: ripe-356
Date: October 2005
Obsolete: ripe-336

% Provider Independent (PI) Assignment Request Form


% RIPE NCC members can use this form to request a PI assignment. Please see 
% ripe-357 for instructions on how to complete this form.


#[GENERAL INFORMATION]#
%
% Please add your RegID.

request-type: pi-ipv4
form-version: 1.1
x-ncc-regid: 


#[ADDRESS SPACE USER]#
%
% Who will use the requested address space?

legal-organisation-name:      
organisation-location: 
website-if-available: 

% Does this End User already have address space that can be
% used for this assignment? (Yes/No)

space-available: 


#[INITIAL INFORMATION]#
%
% Why is PI address space required rather than PA address
% space?

why-pi:

% Is the End User requesting extra address space for routing
% and/or administrative reasons? (Yes/No)

routing-reasons:

% Have you made the End User aware of the consequences and
% disadvantages of PI address space? (Yes/No)

confirmation:


#[ADDRESSING PLAN]#
%
% How will the End User use this address space?
%
%       Subnet       Within     Within   Within
%       size (/nn)   3 months   1 year   2 years   Purpose

subnet:
subnet:
totals:

number-of-subnets: 

% Will the End User return any address space?

address-space-returned: 


#[EQUIPMENT DESCRIPTION]#
%
% What equipment will be used and how will it use the requested
% address space?

equipment-name:
manufacturer-name:
model-number:
other-data:

equipment-name:
manufacturer-name:
model-number:
other-data:


#[NETWORK DESCRIPTION]#
%
% Please add more information if you think it will help us understand
% this request.

<add more information>


#[NETWORK DIAGRAM]#
%
% Have you attached a network diagram to this request? (Yes/No)

diagram-attached:


#[DATABASE TEMPLATE(S)]#
%
% Please complete all of the fields below. 

inetnum:       <leave empty>
netname:       <add netname>
descr:         <add End User organisation name>
country:       <add country code>
org:           <add org-ID>
admin-c:       <add nic-handle of administrative contact>
tech-c:        <add nic-handle of technical contact>
status:        ASSIGNED PI
mnt-by:        RIPE-NCC-HM-PI-MNT
mnt-lower:     RIPE-NCC-HM-PI-MNT
mnt-by:        <add mntner name>
mnt-routes:    <add mntner name>
mnt-domains:   <add mntner name>
changed:       hostmaster@ripe.net
source:        RIPE


#[END of REQUEST]#
