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. #[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: netname: descr: country: org: admin-c: tech-c: status: ASSIGNED PI mnt-by: RIPE-NCC-HM-PI-MNT mnt-lower: RIPE-NCC-HM-PI-MNT mnt-by: mnt-routes: mnt-domains: changed: hostmaster@ripe.net source: RIPE #[END of REQUEST]#