% Provider Aggregatable (PA) Assignment Request Form
% RIPE NCC members can use this form to request a PA assignment. Please see
% ripe-489 for instructions on how to complete this form.
% Please add your RegID.
#[ADDRESS SPACE USER]#
% Who will use the requested address space?
% Does this End User already have address space that can be
% used for this assignment? (Yes/No)
% 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
% Which netname will you use for this assignment?
% Will the End User return any address space?
% What equipment will be used and how will it use the requested
% address space?
% Please add more information if you think it will help us understand
% this request.
<add more information>
% Have you attached a network diagram to this request? (Yes/No)
#[END of REQUEST]#