RIPE NCC Doc-ID: ripe-488 Date: January 2010 Obsolete: ripe-315, ripe-381 % Provider Aggregatable (PA) Assignment Request Form % RIPE NCC members can use this form to request a PA assignment. Please see % http://www.ripe.net/ripe/docs/iprequestsupport.html. for instructions on % how to complete this form. #[GENERAL INFORMATION]# % % Please add your RegID. request-type: pa-ipv4 form-version: 1.2 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: #[ADDRESSING PLAN]# % As of 1 January 2010 assignments are for a period of up to 12 months. % As of 1 July 2010 assignments are for a period of up to 9 months. % As of 1 January 2011 assignments are for a period of up to 6 months. % As of 1 July 2011 assignments are for a period of up to 3 months. % % How will the End User use this address space? % % Subnet Immediate Intermediate Entire Purpose % size (/nn) Requirement Requirement Period subnet: subnet: totals: number-of-subnets: % Which netname will you use for this assignment? netname: % 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: #[END of REQUEST]#