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IPv4 First Allocation Request Form

% IPv4 First Allocation Request Form

% RIPE NCC members can use this form to request their first IPv4 Allocation.
% Please see http://www.ripe.net/ripe/docs/first-allocation-support for instructions on how to complete this form.

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

request-type: ipv4-first-alloc
form-version: 1.2
x-ncc-regid:


#[REQUESTER TEMPLATE]#
%
% Please add your contact details.

name:
phone:
e-mail:


#[ADDRESS SPACE USAGE]#
%
% Will you make assignment(s) from the requested allocation? (Yes/No)

usage-confirmation:


#[DATABASE TEMPLATE(S)]#
%
% Please complete all of the fields below.
%
% You can find more information on how to complete these fields
% in the supporting notes.

inetnum:    <leave empty>
netname:    <leave empty>
descr:      <leave empty>
country:    <add country code>
org:        <leave empty>
admin-c:    <add nic-hdl of administrative contact>
tech-c:     <add nic-hdl of technical contact>
status:     ALLOCATED PA
mnt-by:     RIPE-NCC-HM-MNT
mnt-lower:  <add mntner name>
mnt-routes: <add mntner name>
notify:     <add email address>
changed:    hostmaster@ripe.net
source:     RIPE

#[INSERT SUPPLEMENTAL COMMENTS]#
%
% You can add more information if necessary.

<add more information>


#[END of REQUEST]#