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EIA IP Change Request Form

ALERT! Form must be submitted before placing the EVC Change Order.

This form is only required when changing an IP Subnet size
(i.e. /30 to /29; /30 to /28).
*Required Field

Submitted by:

CC:

List additional customer contact emails to carbon copy on the form submission confirmation.

Customer Information (End User Address)

Customer Point-of-Contact Information (Carrier Customer)

Requested Netblock

Standard Configuration Request: /30, /29, /28

These can be requested in two configurations:

- - - - - -

WAN/LAN (TOS 000000)

When requested the configurations will be as follows depending on the size of the block requested:

/30 WAN and a /30 LAN

/30 WAN and a /29 LAN

/30 WAN and a /28 LAN

- - - - - -

FLAT/LAN (TOS 111111)

When requested the configurations will be as follows depending on the size of the block requested:

A single /30 facing directly to Frontier

A single /29 facing directly to Frontier

A single /28 facing directly to Frontier

- - - - - -

Are you replacing Frontier-assigned existing IPs?

If the customer is requesting a larger IP block (i.e. /30 to a /29), the current /30 IP block will be reclaimed and new /29 IP block will be assigned.

IP Address Type*

IPv4 CIDR Block Requested*

IPv6 CIDR Block Requested*

Current IP Address Usage

Provide the numbers detailing your current network to justify the requested IP Block.

Fields are required. Zero may be entered as a valid entry, however, total of all IP Address Usage fields must justify requested block size.