This RIPE document has been obsoleted due to the RIPE NCC reaching the last /8 of IPv4 address space.
% 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.
% Please note that the End User should have a signed "End User
% Assignment Agreement" with either the sponsoring LIR or the RIPE NCC.
% Please add your RegID.
#[ADDRESS SPACE USER]#
% Who will use the requested address space?
% Is this request being sent by a sponsoring LIR on behalf of
% an End User? (Yes/No)
% 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)
% Does this End User already have address space that can be used for
% this assignment? (Yes/No)
% Why is PI address space required rather than PA address space?
% Is the End User requesting extra address space for routing and/or
% administrative reasons? (Yes/No)
% Is the End User aware of the consequences and disadvantages
% of PI address space? (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
% 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>
% 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
% Have you attached any files/documents to this request? (Yes/No)
% Please complete all of the fields below.
inetnum: <leave empty>
netname: <add netname>
descr: <add End User organisation name>
country: <add country code>
org: <add org-ID>
admin-c: <add nic-handle of administrative contact>
tech-c: <add nic-handle of technical contact>
status: ASSIGNED PI
mnt-by: <add mntner name>
mnt-routes: <add mntner name>
mnt-domains: <add mntner name>
#[END of REQUEST]#