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Issue 2 April 1996 A-3
PA001 Form
PA001 Administration Request Form
Please Fax this form to (303)488-5816 ATTN: System Manage
Call (800)548-8861 Ext. 86767 if you need assistance.
International customers contact your local support organization.
DOSS ORDER Number: ________________________ Cut Date: __/__/__
Customer Information
Company Name: ________________________________________________________
Contact Name: _________________________________________________________
Contact Phone: (_____) _____-________ Ext _________
Address: ______________________________________________________________
City: _____________________________________ State: _____ Zip Code ______
AT&T Information
Account Team
Contact: _________________________________________________________
Phone: (_____) _____-________ Ext _________
Project Manager
Contact: _________________________________________________________
Phone: (_____) _____-________ Ext _________
System Information
Network Manager Platform Type:
HP-UX Cabletron SPECTRUM
HP SunOS IBM NetView
Proxy Agent Platform: ___________________________________________________
Proxy Agent System Name (uname): ________________________________________
Proxy Agent IP (Network) Address: ________________________________________
NMS (Network Manager) IP (Network) Address: ______________________________
Community String (default is "public"): ______________________________________
PBX Alarms will be routed to? : TSC/INADS ________________________________
Trouble Tracker Information
Complete this section only if you want the Proxy Agent to route alarms to a Trouble Tra
Alarm Receiver Number: (_____) _____-________ Ext _________