Utilization Percentage For

Please complete only the sections that apply to your organi

Subnet Utilization Percentage
192.0.2.0/24 (example) 84%
198.51.100.0/24 (example) 92%

Detailed Utilization Informat

Please complete only the sections that apply to your organi
Dynamic p

Subnet assigned City/Region Served

192.0.2.0/26 (example) Reston, VA (example)

Static assignments to customers, such as leased line, colocation, or virtual private/dedicate

IP/Subnet Company
192.0.2.71 (example) My Company (example)
192.0.2.72 (example) ABC Company (example)
192.0.2.64/29 (example) XYZ Manufacturing (example)

Shared web hosting platforms, list each IP address used and pro
IP/Subnet Domain
192.0.2.73 (example) example.com (example)

Internal utilization, list each IP/subnet assigned and

IP/Subnet Device Name/purpose
192.0.2.74 (example) core router (example)
192.0.2.75 - 192.0.2.78 (example) DNS Server for internal domains, used for external queries (example)
192.0.2.79 (example) mx1. mail exchanger for email – spam filtering (example)

Two Year Projected N

Please complete this section for your entire tw
Projected Needs - Subnet Mapp
Subnet Description
x.x.x.0/26 NAT pool (example)
x.x.x.64/27 Database cluster (example)
x.x.x.96/29 Mail Servers - rDNS (example)
x.x.x.104/29 Web Servers (example)
x.x.x.112/28
x.x.x.128/26 Staff VPN Access (example)
x.x.x.192/26

Note: ARIN requires that all documentation data be accurate and verifiable. If we’re unable to verify t
data is accu
ALLOC-121118
ization Percentage For Previous Allocations
that apply to your organization's usage OR as described in your ticketed reply.

led Utilization Information For Last Allocation

that apply to your organization's usage OR as described in your ticketed reply.
Dynamic pools:
Service type
(xDSL, wireless, etc) Number of Customers Served
Wireless (example) 37 (example)

ion, or virtual private/dedicated servers, list each IP/subnet assigned along with the corresponding customer
Contact/Customer Name Physical Address / Phone
Sam Jones (example) 123 Any Street, Any Town USA 12345 (703.227.0660)
Mike Smith (example) 123 My Street, My Town USA 12345 (703.227.0660)
Sally Owens (example) 123 This Street, This Town USA 12345 (703.227.0660)

each IP address used and provide at least one active customer domain hosted on each.
Address Contact Information
123 Any Street, Any Town USA 1 email@example.com

each IP/subnet assigned and the corresponding device name and purpose.

or external queries (example)

tering (example)

Two Year Projected Need Information

section for your entire two year need - Required for every request.
Projected Needs - Subnet Mapping for Requested Block
Geographic Location 1-year use (/32s)
Reston VA 30
Reston VA 25
Reston VA 5
Reston VA 6

Ashburn VA 45

111

ble. If we’re unable to verify the accuracy of the data provided, we may request additional information to ver
data is accurate.
ALLOC-121118
eply.

eply.

Peak Utilization %
62% (example)

responding customer name. `

Contact Information
email@example.com
abc@example.com
xyz@example.com

2-year use (/32s)

60
32
8
8

64

172

nal information to verify your request

ALLOC-121118