Form A – HNI Application

Step 1 of 4

Entity Requesting Assignment *

Select the type of entity requesting the HNI (select one) *

Public Network Operator (commercial or government, or its authorized agent operating as a Mobile Virtual Network Operator (MVNO)) offering mobility services in the U.S. with a need to roam onto/from commercial networks or,
Provider of a service profile management system (e.g., HLR, Home AAA) based in the U.S. for end user devices that can access public networks in the U.S.

Indicate the radio interface protocol used by the network equipment or end user devices (may choose more than one) *

Provide Evidence of Authorization

(i.e., FCC wireless license, agreement with service provider (if MVNO))

Wireless License Number

Date of Issuance//

Upload license

Click or drag a file to this area to upload.

Note: If information is under Non-Disclosure Agreement (NDA), please mark documentation as Confidential and the IMSI-A will treat the documentation accordingly

The applicant must certify that the HNI will be used for mobile applications, and the service provided will have at least two of the following characteristics (check two):

Access to a service profile management system *

Access to a service profile management system – Service profile management is the ability to access and manipulate a service profile. The user, the subscriber or the provider can perform service profile management.

Terminal Mobility *

Terminal Mobility – The ability of a terminal to access telecommunication services from different locations and while in motion, and the capability of the network to identify and locate that terminal.

Personal Mobility *

Personal Mobility – The ability of a user to access telecommunications services at any terminal on the basis of a personal identifier, and the capability of the network to provide those services according to the user’s profile. Personal mobility involves the network capability to locate the terminal associated with the user for the purpose of routing.

Add any special considerations if applicable, per section 8.4.2 or an addendum.

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Applicant Contact Information

Contact Name *

Contact Title *

Company *

Address *

City *

State *

Zip Code *

Country *

Phone *

Email *

Annual Billing Contact Information

Billing Contact Name *

Billing Contact Title *

Billing Company *

Billing Address *

Billing City *

Billing State *

Billing Zip Code *

Billing Country *

Billing Phone *

Billing Email *

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