1)
(ITU-T Recommendation E.169.2)
To be returned to : UIPRN Registrar
International Telecommunication Union
Telecommunication Standardization Bureau
Place des Nations
CH - 1211 GENEVA 20, Switzerland
Fax : +41 22 730 6200
Tel : +41 22 730 6220
Email: universalnumbers@itu.int
Part A to be filled out by the applicant
Contact name
Transmittal date: (a)_______________
(b) _____________________________________________
Address (c ) _____________________________________________
_____________________________________________
Telephone number
Fax number
Email Address
(d) +____________________
+____________________
____________________
The following UIPRN has been implemented: (e)
+979 X __ __ __ __ __ __ __ __
Date of activation is: (f) ____
Day
____
Month
Coordination (reference) number: (g) ____________________
____
Year
IPRS customer name
Customer's address
(h) _____________________________________________
_____________________________________________
_____________________________________________
Remarks : ( i) _____________________________________________
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1
) This Form must be returned no later than 180 days after the reservation of a UIPRN number with the
Registrar, otherwise the number will be cancelled.