IP Justification Form | Allstream Support Center

Order Number

Order Number (Previously obtained from Allstream customer service) *

Customer Information

Company Name *

Allstream Sales or Customer Service Representative

Customer Account Number *

Allstream Market *

Primary Contact Information

Contact Name *

Contact Phone Number *

Contact Email Address *

Technical Contact Information

Is your technical contact the same as your primary contact? *

Yes

No

Technical Contact Name or Company *

Technical Contact Phone Number *

Technical Contact Email Address *

IPv4 Request Information

Number of IP Addresses Requested *

Number of Routers *

Number of Servers *

Number of Workstations *

Number of Web Hosts *

Other Use *

Please describe

Please describe your planned usage of new IP addresses and any special requests *

IP Usage Information

Are you an Internet Service Provider? *

Yes

No

Will you assign IP addresses to your customers? *

Yes

No

Do you provide dial-up Internet access? *

Yes

No

Do you currently have IP addresses issued to you by Allstream? *

Yes

No

Please list the current range of IP addresses that Allstream has assigned to you *

Please provide the number of Allstream IP addresses that are currently being used for each of the following:

Number of Routers *

Number of Servers *

Number of Workstations *

Number of Dial-ups *

Number of Web Hosts *

Other Use *

Please describe

Do you currently have IP addresses from another Internet service provider? *

Yes

No

Will you be returning the IP addresses to that service provider? *

Yes

No

Please list all IP address blocks from other providers *

Please check this box to indicate that you understand and acknowledge that all IP address space assigned to you by Allstream is non-portable and will be released back to Allstream if you discontinue Allstream's Internet service. *

I understand and acknowledge these terms.