ARIN End-User Network Request Template
Instructions for Completing the ARIN End-User Network Request Template are located at http://ww1.arin.net/library/templates/net-end-user.txt
Template: ARIN-NET-END-USER-3.0.1
As of June 2002
JUSTIFICATION SECTION
------------------ EXISTING NETWORK SUB-SECTION --------------------
1. Internet Connectivity:
List the name of your Internet Service Provider(s).
2. Existing IP Addresses:
List all existing IP addresses utilized on your network.
3. Existing Network Topology:
Explain how addresses have been utilized, using the format below.
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Subnet# Subnet Mask Hosts Description
-------------------------------------------------------------
1.0 255.255.255.224 8 Network
1.1 255.255.255.224 17 Engineering
1.2 255.255.255.224 12 Manufacturing
1.3 255.255.255.224 5 Management
1.4 255.255.255.224 10 Sales
1.5 255.255.255.224 7 Finance
1.6 255.255.255.224 0 (spare)
------------------------ HOST SUB-SECTION --------------------------
4. Initial Host Count:
5. Host Count within One Year:
6. Requested Network Topology:
Explain how the requested addresses will be utilized both initially and within one year, using the format below.
---------------------------------------------------------------------
Hosts Hosts
Subnet# Subnet Mask Now 1yr Description
------------------------------------------------------------------------
1.0 255.255.255.224 8 16 Network
1.1 255.255.255.224 17 22 Engineering
1.2 255.255.255.224 12 12 Manufacturing
1.3 255.255.255.224 5 9 Management
1.4 255.255.255.224 10 15 Sales
1.5 255.255.255.224 7 8 Finance
1.6 255.255.255.224 0 0 (spare)
7. Additional Information:
Provide additional information for ARIN to consider for this network request.
ORGANIZATION SECTION
Provide a registered ARIN organization ID on line 8 **OR** complete lines 9 and 10.
8. Org ID:
Enter a registered ARIN Organization ID.
9. Org Name:
Provide the organization name using no more than 150 characters.
10. Org Address:
Include street, city, state or province and postal code, if appropriate, and country code in this field.
REGISTRATION SECTION
11. Prefix Length Requested:
Enter the prefix length of the network requested, e.g. /20, /19. **REQUIRED**
12. Network Name:
Choose a network name using no more than 50 characters. **REQUIRED**
13a. IN-ADDR Name Server:
13b. IN-ADDR Name Server:
If the network has in-addr.arpa servers, list the hostnames of at least two name servers. Do not provide IP addresses.
Duplicate line 13b to specify additional servers.
CONTACT SECTION (Optional)
The person or role in this section serves as a supplemental contact to the organization POC(s). To specify multiple contacts, duplicate lines 14 and 15.
14. POC Type:
Specify T for Technical, AB for Abuse or N for Network Operations Center.
15. POC Handle:
Provide a registered ARIN POC handle.
PUBLIC COMMENTS SECTION (Optional)
16. Public Comments:
Comments listed here will appear in ARIN's WHOIS database.
END OF TEMPLATE