-------------------------------------------------------------------
APNIC Document identity

 Title:    APNIC IPv4 ISP Request Form

 Short title:			  isp-address-request
 Document ref:  		  APNIC-084
 Version:   			  003
 Date of original publication:    1 December 2001
 Date of this version:   	  1 December 2002
 Review scheduled:  		  n/a
 Obsoletes: 			  All previous versions
 Status:  			  Active
 Comments:  			  This document also exists as an
                                  online web form (with appropriate
                                  modifications).
--------------------------------------------------------------------


		APNIC IPv4 ISP Request Form



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

  This form is for use by organisations requesting IPv4 allocations
  that they will use for addressing their own infrastructure and
  making assignments to customers.

  It may be used by APNIC members only.

  There is also an online web version of this form at:

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


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

  If you are seeking a portable address asignment under APNIC's
  multihoming, IXP or critical infrastructure policies, then use the
  "APNIC Portable Assignment Request Form", at:

     ftp://ftp.apnic.net/apnic/docs/portable-assign-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


  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
-----------------

  Allocations are available to current APNIC members only.

  Membership information:

     http://www.apnic.net/member

  A summary of APNIC's fees is available at:

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

  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:

     <helpdesk@apnic.net>

  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:

     <hostmaster@apnic.net>

  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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