Request form #1 for: An IEEE Standard Group MAC Address

The Standard Group MAC Address is for use by standards developers.

All MAC protocol data units contain addressing information. The addressing information consists of two fields: the destination MAC address and the source MAC address. Both of these address fields are 48-bit fields; the structure and semantics of the address fields are defined in ISO/IEC 10039.

After completing this form, please attach an explanatory/rationale statement detailing the intended use of the Standard Group MAC Address assignment to this form. The application can be faxed or mailed. The review and approval process of the application will be completed in less than 150 days. If the IEEE Registration Authority places the application on hold for any reason, the applicant has thirty (30) days to rectify the problem. If the problem is not rectified within thirty (30) days, the application process will be terminated and the applicant can re-apply once they have resolved the issue. You will receive your assignment within seven (7) business days of approval. Make sure that all sections of this form are completed. IEEE does not honor requests for applicant-specified identifiers.

TO BE COMPLETED BY REQUESTOR:   Administrator's Name (if different from requestor)
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Requestor Name   Administrator Name
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Organization Name   Organization Name
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Mailing Address   Mailing Address
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Mailing Address Line 2   Mailing Address Line 2
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Phone Number   Phone Number
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Fax Number   Fax Number
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E-mail Address   E-mail Address

Requestor/company hereby agrees to indemnify and hold IEEE harmless from claim arising out of Requestor's use of Assignments or misuse of any assigned number.

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Your signature Date

Please return completed form to:  
IEEE Registration Authority  
IEEE Standards Association Phone: +1-732-465-6481
445 Hoes Lane Fax: +1-732-562-1571
Piscataway, NJ 08854 e-mail: ieee-registration-authority@ieee.org


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