.
European IP Address Space Request Form
1 March 1996
____________________________________________________________
European IP Address Space Request Form
RIPE NCC
1 March 1996
Expiry Date: 31 May 1996
To whom it may concern,
Before you complete this form, please ensure that you read
the information outlined in the "Supporting Notes for
European IP Address Space Requests" (document ripe-128)
carefully before submitting your application for an IP
number. The form will be accepted by local Internet
Registries across Europe.
Please note that statements made in this form can be used in
consideration of future requests that are made.
Once completed, please return this document to your local
Internet Registry.
IMPORTANT NOTE:
This document is valid until May 31t, 1996. An updated
document will be sent out when due.
Part A - Administrative Details The information supplied for
this section together with the assigned network numbers will
be entered into a database of European network numbers and
their contact information which is accessible by the whole
Internet community.
NETWORK TEMPLATE
netname:
descr:
descr:
country:
admin-c:
tech-c:
changed:
source: RIPE
____________________________________________________________
ripe-129.txt Expires 31-May-96 Page 1
European IP Address Space Request Form
1 March 1996
____________________________________________________________
PERSON TEMPLATE
person:
address:
address:
address:
address:
phone:
fax-no:
e-mail:
nic-hdl:
changed:
source: RIPE
PERSON TEMPLATE
person:
address:
address:
address:
address:
phone:
fax-no:
e-mail:
nic-hdl:
changed:
source: RIPE
Please note that you will have to include a separate person
template for each person referenced as a contact unless the
information about the person in the RIPE database is still
valid.
The information given above will be entered into a database
of European network contacts which is accessible by the
whole Internet community. Please refer to the RIPE NCC
leaflet on the "Network Management Database" for details 
% Provider Aggregatable (PA) Assignment Request Form
% RIPE NCC members can use this form to request a PA assignment. Please see
% ripe-489 Link: /publications/docs/ripe-489/ for instructions on
how to query the database.
____________________________________________________________
ripe-129.txt Expires 31-May-96 Page 2
European IP Address Space Request Form
1 March 1996
____________________________________________________________
Part B - Technical Details
Information supplied below helps us to evaluate and process
your request. It will be kept in strict CONFIDENCE and is
for internal use only. It will NOT be entered into the RIPE
Network Management Database.
TECHNICAL TEMPLATE
request-type:
machine-0:
machine-1:
machine-2:
subnet-0:
subnet-1:
subnet-2:
inet-connect:
country-net:
____________________________________________________________
ripe-129.txt Expires 31-May-96 Page 3
European IP Address Space Request Form
1 March 1996
____________________________________________________________
Part C - Network Details
Please submit a description of your network layout, includ-
ing all devices which will require unique IP addresses. The
more detail you supply in this section, the easier it will
be to evaluate your case and allocate you the requested IP
numbers.
Current network layout:
Network deployment plans: (year 1 & year 2)
(Please ensure you have read the "Additional Hints" section
in the "Supporting Notes" on organisations requesting addi-
tional class C numbers or class B numbers). Please describe
your planned allocation of complete this form.
#[GENERAL INFORMATION]#
%
% Please add your RegID.
request-type: pa-ipv4
form-version: 1.2
x-ncc-regid:
#[ADDRESS SPACE USER]#
%
% Who will use the requested address space.
____________________________________________________________
ripe-129.txt Expires 31-May-96 Page 4
European IP Address Space Request Form
1 March 1996
____________________________________________________________
Addressing plan:
Please give an overview of your addressing plan.
Number of hosts per subnet for
Subnet Subnet mask Max Now Year-1 Year-2 Remarks
--------------------------------------------------------------------
Totals:
Part D - Enterprise Allocation History
If any part of your organisation (including subsidiaries and
the parent company) has received address space in the past,
please specify the actual network numbers allocated. Please
also give details, if any applications for additional
address space have been rejected in the past. Finally please
include a brief overview of your company structure, includ-
ing details of the parent company, subsidiaries and contact
persons. Please continue on a separate sheet if necessary.
____________________________________________________________
ripe-129.txt Expires 31-May-96 Page 5
European IP Address Space Request Form
1 March 1996
____________________________________________________________
Part E - Contact Details Complete the section below *ONLY
IF* you are making an application on behalf of another
organisation.
This application is made by:
name:
organisation:
country:
phone:
fax-no:
e-mail:
On behalf of the following organisation:
name:
organisation:
country:
phone:
fax-no:
e-mail:
Part F - Non European Requests
If your request is for the Asian-Pacific Region you should
sent your application form to: AP-NIC, c/o United Nations
University, 3-70 Jingumae 5-chome, Shibuya-ku, Shibuya-ku,
Tokyo 150, Japan, Telephone: +81-3-5276-3973, Fax:
+81-3-5276-6239, Email: <[email protected]>
The InterNIC serves as default for the rest of the world.
Their contact details are: Network Solutions Inc, Attention:
InterNIC Registration Service, 505 Huntmar Park Drive, Hern-
don, VA 22070, USA. Telephone: +1 703 742 4777, fax: +1 703
742 4811. Email: <[email protected]>
____________________________________________________________
ripe-129.txt Expires 31-May-96 Page 6 space?
legal-organisation-name:
organisation-location:
website-if-available:
% Does this End User already have address space that can be
% used for this assignment? (Yes/No)
space-available:
#[ADDRESSING PLAN]#
% 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
subnet:
subnet:
totals:
number-of-subnets:
% Which netname will you use for this assignment?
netname:
% 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.
<add more information>
#[NETWORK DIAGRAM]#
%
% Have you attached a network diagram to this request? (Yes/No)
diagram-attached:
#[END of REQUEST]#