Short Form 1040/19 EZ

[Jim Fleming]

Here is a short form 1040/19 EZ that the
U.S. Government could be using to allocate /19 CIDR Blocks.


@@@@@@@@@  EXAMPLE @@@@@@@@@@@@@@@@

1. Name, address, and State of Incorporation.
	(Include copy of the Certificate of Incorporation)

	_______________________________________
	_______________________________________
	_______________________________________

2. Previously allocated blocks that will be returned 60 days
	after the new allocation is activated.
	__________________________________
	__________________________________
	__________________________________
	__________________________________

3. Contact information on the TWO service providers that have
	agreed to advertise your allocation. Please attach
	standard routing afidavits from each provider.
	
	1. ________________________________

	2. ________________________________

4. Business References:
	
	1._____________________________
	
	2._____________________________
	
	3._____________________________

3. Date Submitted and signed by an officer of the company

	______________________________________


Please submit the above information along with a $500
application fee drawn on a U.S. bank. Please allow
at least 5 days for processing from the date received.

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--
Jim Fleming
Unir Corporation

e-mail:
JimFleming at unety.net
JimFleming at unety.s0.g0 (EDNS/IPv8)