You are on page 1of 2

Declaration Form for Requesting Public IP-

Address

To
Date:
The Incharge
Place:
Network Operations
Rail Wire ICT Private Ltd
113/1B, 2nd Building, 1st Floor
ITPL Main Road
Kundalahalli
Bangalore-560037

Dear Sir,

Sub: Request for Public IP Address

We have been using Rail Wire broad band


connection since (-------) months. The internet
bandwidth connection taken from Rail Wire will
continue to be used strictly for my internal purposes.
We will not be using it for any kind of illegal
activities. We request you to kindly provide us a
public ip.

User Name:
Address:
Purpose of Public IP:
LCO/RailTel Partner:

Railwire Authority Yours


Sincerely,
--------------------------------------------------------------------------
------------------
For Office Use Only

IP Address Assigned: Subnetmask(not applicable for pppoeCust.):

Distribution Router IP: