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APNIC Document identity
 Short title: isp-address-request
 Title:       APNIC IPv4 ISP Request Form
 Document ref:      APNIC-084    Version:    002
 Approved:          n/a          Active:     1 July 2002
 Review scheduled:  n/a          Obsoletes:  APNIC-065
 Status:            Active       Comments:   This document also 
     exists as an online web form (with
     appropriate modifications).
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APNIC IPv4 ISP Request Form

What is this form used for?
---------------------------

http://www.apnic.net/services/ipv4/index.html

Other IP address request forms
------------------------------

If you are seeking address space under APNIC's small multihoming
assignment policy, then use the "Small Multihoming Assignment
Request Form", at:

ftp://ftp.apnic.net/apnic/docs/small-multihoming-request

If you are an APNIC recognised confederation, then use the
"Confederation Internet Address Request Form", at:

ftp://ftp.apnic.net/apnic/docs/confed-address-request

ftp://ftp.apnic.net/apnic/docs/ixp-assign-request

If you are seeking an IPv6 allocation, then use the "APNIC IPv6
Allocation Request Form" at:

ftp://ftp.apnic.net/apnic/docs/ipv6-alloc-request

Eligibility for first IPv4 allocation
-------------------------------------

Organisations seeking their first IPv4 allocation must meet the
minimum criteria described in "Policies for Address Space Management
in the Asia Pacific Region".

If the organisation for which you are requesting address space does
not meet the minimum criteria, you will be advised to seek address
space from a service provider rather than from APNIC. For more
information, see:

http://www.apnic.net/docs/policy/add-manage-policy.html

Fees and accounts
-----------------

http://www.apnic.net/member

Members making their first Internet address resource request from
APNIC are subject to the Resource Services Application Fee. For more
information, see:

http://www.apnic.net/member/feesinfo.html

Help guide for this form
------------------------

A full help guide for this form is available at:

http://www.apnic.net/services/help/isp_txt

You may also wish to read "Quick tips for requesting IP
addresses", at:

http://www.apnic.net/info/faq/isp-request-tips.html

Questions
---------

If you have other questions, please contact us at:

< This e-mail address is being protected from spambots. You need JavaScript enabled to view it >

Or, if you would prefer to phone or fax us with your questions,
please refer to our contact details and office hours at:

http://www.apnic.net

Submitting this form
--------------------

First, complete the form templates below in plain ASCII text. Then,
submit the completed templates (not including this introductory
information) by email to:

< This e-mail address is being protected from spambots. You need JavaScript enabled to view it >

Please note that this form will first be parsed by machine.
Therefore, you must ensure that:
- your email is sent in plain ASCII text only
- you do not modify any of the template lines starting with #[
- you do not modify any of the field names in the templates.

NOTE: PLEASE DO NOT INCLUDE THIS HEADER WITH YOUR APPLICATION.

- - - - - - - - - - - - - FORM STARTS - - - - - - - - - - - - - - -

#[NETWORK TEMPLATE]#

netname:
descr:
descr:
country:
admin-c:
tech-c:
remarks:
changed:
mnt-lower:
source: APNIC

#[FIRST ALLOCATION TEMPLATE]#

min-criteria:
renumber-date:
renumber-org:
prefix:

#[ISP TECHNICAL TEMPLATE]#

acct-name:
connectivity:
conn-provider:
all-0s-subnets:
all-1s-subnets:
supernets:
subnets:
cust-network:
cust-network:
infrastructure:
infrastructure:
cable-bootstrap:
cable-list:
network-plan:
network-plan:

#[TEMPLATES END]#

#[ADDITIONAL QUESTIONS]#
Please answer the following questions that apply to your request.

1. If this is your first request for IPv4 address space, is there any
reason you are not able to get address space from your Internet
service provider?

2. If you wish to renumber out of any existing IPv4 address ranges,
what are the details of the address ranges, and the name, phone
number and email address of the organisation to which you will be
returning those ranges. (If you already provided this information
in the FIRST ALLOCATION TEMPLATE, please skip this question.)

3. Do you have any additional comments (refer to "Additional Comments"
in the help guide for things to include here)?

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