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 ripe-362 for instructions on how to complete this form.


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

request-type: ipv4-first-alloc
form-version: 1.1
x-ncc-regid: 


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

name: 
phone: 
fax-no: 
e-mail: 
nic-hdl:

 
#[CURRENT ADDRESS SPACE]#
%
% Are you currently using any address space? (Yes/No) 

current-address: 


#[CURRENT ADDRESS SPACE PREFIX TEMPLATE]#
%
% If yes, which address prefixes are you using?

actual-prefix:
actual-prefix:


#[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 (ripe-362). 

inetnum:    <leave empty>
netname:    <leave empty>
descr:      <add LIR organisation name> 
country:    <add country code>
org:	    <add org-ID>
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:    [email protected]
source:     RIPE 


#[INSERT SUPPLEMENTAL COMMENTS]#
%
% Please add more information if you have specific addressing needs.

<add more information>


#[END of REQUEST]#