Provider Independent (PI) Assignment Request Form RIPE NCC Document ID: ripe-453 Date: February 2009 Obsoletes: ripe-336, ripe-356 ------------------------88---------------------- % Provider Independent (PI) Assignment Request Form % RIPE NCC members (LIRs) and Direct Assignment Users can use this form % to request a PI assignment. Please see "Supporting Notes for the % Provider Independent (PI) Assignment Request Form" for instructions on % how to complete this form. % http://www.ripe.net/ripe/docs/pi-requestsupport.html % % Please note that the End User should have a signed "End User % Assignment Agreement" with either the sponsoring LIR or the RIPE NCC. #[GENERAL INFORMATION]# % % Please add your RegID. request-type: pi-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: % Is this request being sent by a sponsoring LIR on behalf of % an End User? (Yes/No) end-user-of-sponsoring-lir: % If yes, please confirm that the "End User Assignment Agreement" % contains all of the elements listed in paragraph 2.0 of "Contractual % Requirements for Provider Independent Resource Holders in the % RIPE NCC Service Region".(Yes/No) confirmation: % 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: % Is 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. #[SUPPORTING DOCUMENTATION]# % % If this request is being sent by a sponsoring LIR on behalf of % an End User, please attach a copy of the signed "End User Assignment % Agreement" and the company registration papers of the End User. % You can also attach a network diagram or other supporting % documentation. % % Have you attached any files/documents to this request? (Yes/No) file-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-END-MNT mnt-lower: RIPE-NCC-END-MNT mnt-by: mnt-routes: mnt-domains: changed: hostmaster@ripe.net source: RIPE #[END of REQUEST]#