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

Personal data

It can be found on the left corner of your last bill or payment statement, next to the document number {{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}}
Please indicate the type of change for which you are requesting intervention:
{{errorMessages.infrastructure.required}} {{errorMessages.infrastructure.pattern}}

Installation address

{{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}}
Please inform us at least 8 weeks before the start of the work. We sometimes have to apply for permits or find an alternative.
{{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}}
Type of changes for ‘apartment’
{{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}}
Type of change for ‘house’
{{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}}
Type of change for ‘commercial building’
{{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

Find and upload files or photos to outline your situation (optional). Files should be less than 10 MB and end in .pdf,.txt,.jpg,.jpeg,.gif,.png.

No files uploaded yet

{{file.fileName}}

Please wait, your data is being processed

loader