IPv4 First Allocation Request Form
		
RIPE NCC

Document ID: ripe-272
Date: 20 August 2003
Obsoletes: ripe-235

See also: ripe-273

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#[GENERAL INFORMATION]#
request-type: ipv4-first-alloc
form-version: 1.0
x-ncc-regid: 

#[REQUESTER TEMPLATE]#
%
% Please enter the details of the person at your Local 
% Internet Registry (LIR) who is submitting this request.
name: 
phone: 
fax-no: 
e-mail: 
nic-hdl:

#[IPv4 ASSIGNMENT TICKET NUMBERS]#
%
% Please list the details of the PA assignment requests 
% that you have sent so far for your customers and/or for
% your own infrastructure.
ticket-ID:
organisation-name:
network-name:
total-immediate:
total-size:

 
#[CURRENT ADDRESS SPACE]#
%
% Does the organisation (LIR) that is submitting this 
% request have address space in use for infrastructure 
% Enter "Yes" or "No".
current-address: 

#[CURRENT ADDRESS SPACE USAGE TEMPLATE]#
%
% If you have answered "Yes" to the question above please 
% fill in the following template detailing the usage of 
% your current address space.
%
%       Actual Prefix   Current Use   Future Use   Purpose
subnet: 
totals: 

#[DATABASE TEMPLATE(S)]#
%
% Please fill in the necessary details below so that the 
% Hostmaster can create an inetnum object after allocating 
% a block to you. If it is necessary to create a maintainer object 
% please include that template too.
       

inetnum: 
netname: 
descr:       [Provider / Enterprise] Local Registry
descr:       *specify the name of the LIR's organisation* 
country:     *specify the country code*
admin-c:     *insert nic-handle of administrative contact*
tech-c:      *insert nic-handle of technical contact*
status:      ALLOCATED PA
mnt-by:      RIPE-NCC-HM-MNT 
mnt-lower:   *specify mntner name here*
mnt-routes:  *specify mntner name here*
notify:      *specify e-mail address*
changed:     hostmaster@ripe.net
source:      RIPE 

mntner:      *specify mntner name here* 
descr:       *descriptive comments*         
admin-c:     *insert nic-handle of administrative contact*         
tech-c:      *insert nic-handle of technical contact*         
upd-to:      *specify e-mail address*         
mnt-nfy:     *specify e-mail address*         
auth:        *specify authorisation*         
mnt-by:      *specify mntner name here*         
referral-by: RIPE-DBM-MNT         
changed:     hostmaster@ripe.net       
source:      RIPE

#[INSERT SUPPLEMENTAL COMMENTS]#
%
% Please add any supplementary information that you think 
% may facilitate the evaluation of this request below.

#[END of REQUEST]#
       

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