TES 1

IP-JUST-Ver1.2

IP JUSTIFICATION FORM
In assigning IP Address, TES follow the guideline process and procedure set forth by APNIC (Asia-
Pacific Network Information Centre) and RFC2050.

In order to justify an IP address space assignment, please complete all information listed below:

CUSTOMER INFORMATION DATE:

Customer/Client Name
Postal Address:
Technical Point of Contact:
Title:
Phone Number:
Fax Number:
Email:
Nature of Business:

Number of IPs required:

Purpose/Utilization of IPs requested:(List down servers/equipment that will use new IPs)

I Mr / Ms _____________________________________ is solely responsible in case any abuse or

malicious activity detected from the assigned IPs/Pools.

I. IPs required:

a. /32 (1 Static IP ) 
b. /30 (4 IPs pool) 
a. /29 (8 IPs pool) 
b. /28 (16 IPs pool) 
c. /27 (32 IPs pool) 
d. /26 (64 IPs pool) 
e. /25 (128 IPs pool) 
f. /24 (256 IPs pool) 

_________________

Customer’s Signature
 TES 2
IP-JUST-Ver1.2

For TES use only

Account Manager: ___________________________________________________________

Name Signature

Verified by (Engineering): ___________________________________________________________

Name Signature

Subnet/Prefix Allocated: ___________________________________________________________

WAN IP: ___________________________________________________________

Comments: ___________________________________________________________