Request for ipv4 and ipv6 Address Space



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QuickPacket, LLC - IP Address Space Administration v1.1

Request for IPv4 and IPv6 Address Space

In assigning IPv4 and IPv6 address space to Internet subscribers, QuickPacket, LLC takes guidance from assignment policies and procedures set forth by ARIN (American Registry for Internet Numbers) Number Resource Policy Manual, RFC 2050, and RFC 3177.


In order to justify an IP address space assignment, please completely document all information requested below. IP address space will be assigned based on an analysis of your current and projected usage against strict utilization efficiency guidelines as defined by ARIN Number Resource Policy Manual, RFC 2050, and RFC 3177.
Note: If you need additional space for any of the documentation requested below, please provide the information in a separate document with your request.


I. Customer Information


Date:      

Please complete this section if you are requesting IPv4 and/or IPv6 address space.

Contact Name

     

Company Name

     
Address

     

City

     

State/Province

     

Postal Code

     

Country Code

     

Phone

     

E-Mail

     

Do you have an ARIN Org ID?

 Yes  No

If yes, please provide your Org ID





II. Current IPv4 Address Space Utilization


Please complete this section if you are requesting IPv4 address space.

List ALL IPv4 address space currently assigned from all sources.



IP/Subnet

Number of IPs in use

Assigned By

Will you renumber out of these IPs?

Example:

200.22.22.0/24

256

QuickPacket, LLC

 Yes  No

     

     

     

 Yes  No

     

     

     

 Yes  No

     

     

     

 Yes  No

     

     

     

 Yes  No

If you indicated above that you will be renumbering out of existing IP space, please provide the date when renumbering is expected to be completed:      


III. IPv4 Address Space Request


Please complete this section if you are requesting IPv4 address space.
IPv4 Block Size Requested

     

Describe your planned usage of the requested IPv4 address space. Please be concise.

     



Please provide any additional documentation that will help demonstrate a justified need for the IPs being requested. Items such as location of your reassignments to your customers, nmap, arp table data, IP justification from your customers and so on.


IV. Planned Usage for Requested IPv4 Address Space


Please complete this section if you are requesting IPv4 address space.

Provide detail about projected usage for the IPv4 address space you are requesting. See the instructions at the end of this document for a detailed example.



IP/Subnet

Description

1-month usage

3-month usage

6-month usage

12-month usage

Example:

x.x.x.0/24

Database cluster

128

150

230

256

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     


V. IPv6 Address Space Request


Please complete this section if you are requesting IPv6 address space.
IPv6 Block Size Requested

     

Describe your planned usage of the requested IPv6 address space. Please be concise.

     



Please provide any additional documentation that will help demonstrate a justified need for the IPs being requested. Items such as location of your reassignments to your customers, nmap, arp table data, IP justification from your customers and so on.


VI. IPv6 Address Space Request


Please complete this section if you are requesting IPv6 address space.
Prefix length requested

     
Do you currently have IPv6 space?

 Yes  No

- If you currently have IPv6 address space, please indicate current and planned usage for existing assignments, as well as planned usage for the requested prefix.

- If you are requesting more than a single /48, indicate planned usage.






IPv6 Usage Plan




Network

Prefix

Max

Now

6-mo

1-yr

Description

Example:

3ffe:a00::

/48

/48

/64

/52

/48

Network infrastructure

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     




     

     

     

     

Totals




VII. Additional Comments

     





Please return the completed form to the QuickPacket Sales Department. Failure to provide the requested detail may cause a delay in provisioning your IP Address Space Request.


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