Service & Support - Domain Name Worksheet

DNS Request Form Please complete the on line form for all DNS Requests. This information will be used by the DNS Administrators at AT&T Internet Services to process your specific DNS needs. The DNS Team will send an email confirmation when the request has been completed or with follow-up questions. Only customers with Static IPs are supported. Customers who wish to upgrade to Static service may do so by calling the AT&T sales department. The authoritative Name Servers currently update hourly. The ns1 servers reload 15 minutes after the hour. The ns2 servers reload 45 minutes after the hour. ns1.swbell.net and ns2.swbell.net ns1.pbi.net and ns2.pbi.net ns1.snet.net and ns2.snet.net ns1.ameritech.net and ns2.ameritech.net Fields marked with an asterisk (*) are required.
Type of Request
1. Is this a Reverse DNS (PTR) request, New DNS build, a Modification to an existing DNS build or a Reverse Delegation request (you manage your Zone)?*	Reverse DNS Reverse Delegation New Build Modification
Customer Information
2. Bill To Number (BTN) - number DSL service is on*:	( ) -
3. Assigned LAN/CIDR block*:	/
4. Customer Contact Name:*:
5. Customer Contact Phone Number:*:	( ) -
6. Customer Contact Email Address:*:
7. Service Address, City, State and Zip Code information.
Address:
City:
*State:
Zip:
REVERSE DNS (PTR)
8. Fully Qualified Domain Name (FQDN) for Reverse DNS only or what the MX record points to. Example: mail.domain.com.
9. IP Address LAN IP including gateway IP and "PacBell" Single Static IP only. NOTE: We cannot put Reverse DNS on a WAN IP.
CUSTOM DNS RECORDS (New Build)
10. Do you have a mail server software program?	Yes No
a) Hostname and MX preference you want assigned:	MX preference:
b) IP address you want assigned:
c) Hostname and MX preference of 2nd record:	MX preference:
d) IP address of 2nd record you want assigned:
11. If applicable, provide the Hostname of your web server:
12. If applicable, provide the IP address of your web server:
Additional HOSTS and IP Assignments
13. a) Hostname:
b) IP Address:
14. a) Hostname:
b) IP Address:
15. a) Hostname:
b) IP Address:
REVERSE DELEGATION
16. If you are requesting Reverse Delegation on your IP block, please provide your PRIMARY and SECONDARY name servers and IP address information. Example: ns1.domain.com *IP address* ns2.domain.com *IP address*
Domain Name:
Primary Name Server:
Primary Server IP Address:
Secondary Name Server:
Secondary Server IP Address:
NOTES
17. Use this space to request modifications to an existing DNS build or to provide additional instructions. Please indicate any old records that are to be removed for any modification requests:
There is a $50 charge per domain name for change requests made on an existing domain name, after the initial DNS request. There is a $100 charge for adding an additional domain name.
CONTACT INFORMATION AT&T Internet Services Sales: 877-722-3755 AT&T Yahoo! Web Hosting services: Web Hosting Sales: 888-WEB-HOST (888-932-4678) options 3, 1 Website: http://att.com/webhosting BellSouth DNS Services: Email: dnsupdates@bellsouth.com DSL DNS needs, call: DNS Support 800-833-2120 option 1 Website: http://dialup.pacbell.net/dn_worksheet.html Email: prov-dns@att.com Dedicated Access DNS needs (T1, T3 etc.): Dedicated Enhanced Service Center (DESC) 1-866-937-3664 options 4, 1 Website: http://dedicated.sbcis.sbc.com/NDWS/index.jsp Email: rm-dnsservicesdial@att.com Optional Method of Reverse Delegation (FAQ site): http://dnsteam.sbis.net/dns-group/orevdel.htm Reverse Delegation Policy: http://dnsteam.sbis.net/dns-group/revdelpolicy.htm U-verse services: U-verse DNS support 888 981-2245 Yahoo.com: Customer.s using Yahoo! for DNS 408-349-1572 Send this form by clicking the "Submit Form" button below.