Request for modification or notification of changes to the Proximus cable infrastructure in case of renovation or demolition

Persönliche Daten

Sie finden sie in der linken Ecke Ihrer letzten Rechnung oder Ihres letzten Zahlungsbelegs, neben der Belegnummer {{errorMessages.CusI.required}} {{errorMessages.CusI.pattern}} {{errorMessages.CusI.pattern}} {{errorMessages.CusI.pattern}} {{errorMessages.CusI}} {{errorMessages.CusI.pattern}}
{{errorMessages.FirstName.required}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName}} {{errorMessages.FirstName.pattern}}
{{errorMessages.LastName.required}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName}} {{errorMessages.LastName.pattern}}
Bitte geben Sie die Art der Änderung an, für die Sie eine Intervention beantragen:
{{errorMessages.infrastructure.required}} {{errorMessages.infrastructure.pattern}}

Installationsadresse

{{errorMessages.region.required}} {{errorMessages.region.pattern}}
{{errorMessages.StreetName.required}} {{errorMessages.StreetName.pattern}} {{errorMessages.StreetName.pattern}} {{errorMessages.StreetName.pattern}} {{errorMessages.StreetName}} {{errorMessages.StreetName.pattern}}
{{errorMessages.HouseNumber.required}} {{errorMessages.HouseNumber.pattern}} {{errorMessages.HouseNumber.pattern}} {{errorMessages.HouseNumber.pattern}} {{errorMessages.HouseNumber}} {{errorMessages.HouseNumber.pattern}}
{{errorMessages.Letter.required}} {{errorMessages.Letter.pattern}} {{errorMessages.Letter.pattern}} {{errorMessages.Letter.pattern}} {{errorMessages.Letter}} {{errorMessages.Letter.pattern}}
{{errorMessages.zipCode.required}} {{errorMessages.zipCode.pattern}} {{errorMessages.zipCode.pattern}} {{errorMessages.zipCode.pattern}} {{errorMessages.zipCode}} {{errorMessages.zipCode.pattern}}
{{errorMessages.cityName.required}} {{errorMessages.cityName.pattern}} {{errorMessages.cityName.pattern}} {{errorMessages.cityName.pattern}} {{errorMessages.cityName}} {{errorMessages.cityName.pattern}}
{{errorMessages.CALLBACKCLICountry.required}} {{errorMessages.CALLBACKCLICountry}}
{{errorMessages.CALLBACKCLIPhone.required}} {{errorMessages.CALLBACKCLIPhone.pattern}} {{errorMessages.CALLBACKCLIPhone.pattern}} {{errorMessages.CALLBACKCLIPhone.pattern}} {{errorMessages.CALLBACKCLIPhone}} {{errorMessages.CALLBACKCLIPhone.pattern}}
{{errorMessages.MAILBACKADDR.required}} {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR}} {{errorMessages.MAILBACKADDR.pattern}}
Bitte informieren Sie uns mindestens 8 Wochen vor Beginn der Arbeiten. Manchmal müssen wir Genehmigungen beantragen oder eine Alternative finden.
{{errorMessages.installdate.required}} {{errorMessages.installdate.pattern}} {{errorMessages.installdate.pattern}} {{errorMessages.installdate.pattern}} {{errorMessages.installdate}} {{errorMessages.installdate.pattern}}
{{errorMessages.remarks.required}} {{errorMessages.remarks.pattern}}
{{errorMessages.building_type.required}} {{errorMessages.building_type.pattern}}
Art der Änderungen für âapartmentâ
{{errorMessages.public_infra.required}} {{errorMessages.public_infra.pattern}}
{{errorMessages.public_infra.required}} {{errorMessages.public_infra.pattern}}
{{errorMessages.public_infra.required}} {{errorMessages.public_infra.pattern}}
{{errorMessages.public_infra.required}} {{errorMessages.public_infra.pattern}}
Art der Änderung für âHausâ
{{errorMessages.private_infra.required}} {{errorMessages.private_infra.pattern}}
{{errorMessages.private_infra.required}} {{errorMessages.private_infra.pattern}}
{{errorMessages.private_infra.required}} {{errorMessages.private_infra.pattern}}
{{errorMessages.private_infra.required}} {{errorMessages.private_infra.pattern}}
Art der Änderung für âGewerbegebäudeâ
{{errorMessages.commercial_infra.required}} {{errorMessages.commercial_infra.pattern}}
{{errorMessages.commercial_infra.required}} {{errorMessages.commercial_infra.pattern}}
{{errorMessages.commercial_infra.required}} {{errorMessages.commercial_infra.pattern}}
{{errorMessages.commercial_infra.required}} {{errorMessages.commercial_infra.pattern}}
Upload files

Suchen Sie Dateien oder Fotos, die Ihre Situation verdeutlichen, und laden Sie sie hoch (nicht obligatorisch). Nur Dateien unter 10 MB mit .pdf,.txt,.jpg,.jpeg,.gif,.png-Endungen sind erlaubt.

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