IP Address Request Form

Use this form to request additional IP Addresses up to a full class C in size. If you need a larger network block, please submit your request to ARIN as CenturyLink cannot handle such requests.

Please complete all fields below; missing or inaccurate information will delay your request. This information will be used to submit Shared WhoIs Project (SWIP) documentation to The American Registry for Internet Numbers (ARIN). IP requests will be processed within 72 business hours of receipt.

Contact Information
Company Name
Contact Name
Contact Phone #		--
Contact Hours
Contact Email
Your Circuit
Full Circuit ID
Network (WAN) Address
City, State (ex: Orlando, FL)

Most Recent IP Network Assignment
Provide your most recently assigned IP address block in the field below as well as a clear, concise, and detailed explanation of how the address space is currently being utilized. If you have more than one IP network, include all of the networks, utilization and enough detailed information showing 80% utilization on each of those networks in the Additional Relevant Information field below.
Network Block		# of IPs available		# of IPs in use		Current Utilization
-- /21 /22 /23 /24 /25 /26 /27 /28 /29 /30
New or Additional IP Network Allocation Request
Please select the size of IP network that you are requesting using the Network Block drop down list below. Next, enter the number of IP addresses that you plan to utilize within the next three month period. The request justification should provide a clear, concise, and detailed explanation of how the requested IP address space will be utilized. Note: ARIN requires that at least 80% of the requested address space will be utilized within the next 3 months.
Network Block		# of IPs available		# used in 3 months		Request Justification
-- /21 /22 /23 /24 /25 /26 /27 /28 /29 /30

Additional Relevant Information

Comments / Questions

NOTE: CenturyLink follows ARIN's guidelines for IP address allocation as closely as possible. CenturyLink reserves the right to ask for additional information if deemed necessary.

NOTE: A confirmation e-mail will be sent to the "Contact Email" entered in the form above with the order number included. Please make sure that your e-mail SPAM filter allows the centurylinkservices.net domain name as a safe sender.

If you have any questions about filling out this form or for any requests that cannot be handled through this form, please call 1-800-603-8044 options 1,2 from 8:00AM to 5:00PM Eastern time.