Details of the deceased

We are sorry for your loss.

During this difficult period, we want to make the administrative processing with Proximus run as smoothly as possible for you.

Personal information about the deceased

This information is needed to correctly identify the client.

{{errorMessages.SRCFIRSTNAME.required}} {{errorMessages.SRCFIRSTNAME.pattern}} {{errorMessages.SRCFIRSTNAME.pattern}} {{errorMessages.SRCFIRSTNAME.pattern}} {{errorMessages.SRCFIRSTNAME}} {{errorMessages.SRCFIRSTNAME.pattern}}
{{errorMessages.SRCLASTNAME.required}} {{errorMessages.SRCLASTNAME.pattern}} {{errorMessages.SRCLASTNAME.pattern}} {{errorMessages.SRCLASTNAME.pattern}} {{errorMessages.SRCLASTNAME}} {{errorMessages.SRCLASTNAME.pattern}}
Do you have the customer number of the deceased at hand?
{{errorMessages.customerIDKnown.required}}
{{errorMessages.SRCCUSTOMERID.required}} {{errorMessages.SRCCUSTOMERID.pattern}} {{errorMessages.SRCCUSTOMERID.pattern}} {{errorMessages.SRCCUSTOMERID.pattern}} {{errorMessages.SRCCUSTOMERID}} {{errorMessages.SRCCUSTOMERID.pattern}}
{{errorMessages.SRCBIRTHDATE.required}} {{errorMessages.SRCBIRTHDATE.pattern}} {{errorMessages.SRCBIRTHDATE.pattern}} {{errorMessages.SRCBIRTHDATE.pattern}} {{errorMessages.SRCBIRTHDATE}} {{errorMessages.SRCBIRTHDATE.pattern}}
{{errorMessages.SRCPHONECountry.required}} {{errorMessages.SRCPHONECountry}}
{{errorMessages.SRCPHONEPhone.required}} {{errorMessages.SRCPHONEPhone.pattern}} {{errorMessages.SRCPHONEPhone.pattern}} {{errorMessages.SRCPHONEPhone.pattern}} {{errorMessages.SRCPHONEPhone}} {{errorMessages.SRCPHONEPhone.pattern}}
Invalid address

Identification

This field is mandatory.

My details

{{errorMessages.TGCUSTOMERID.required}} {{errorMessages.TGCUSTOMERID.pattern}} {{errorMessages.TGCUSTOMERID.pattern}} {{errorMessages.TGCUSTOMERID.pattern}} {{errorMessages.TGCUSTOMERID}} {{errorMessages.TGCUSTOMERID.pattern}}
{{errorMessages.TGFIRSTNAME.required}} {{errorMessages.TGFIRSTNAME.pattern}} {{errorMessages.TGFIRSTNAME.pattern}} {{errorMessages.TGFIRSTNAME.pattern}} {{errorMessages.TGFIRSTNAME}} {{errorMessages.TGFIRSTNAME.pattern}}
{{errorMessages.TGLASTNAME.required}} {{errorMessages.TGLASTNAME.pattern}} {{errorMessages.TGLASTNAME.pattern}} {{errorMessages.TGLASTNAME.pattern}} {{errorMessages.TGLASTNAME}} {{errorMessages.TGLASTNAME.pattern}}
{{errorMessages.TGEMAIL.required}} {{errorMessages.TGEMAIL.pattern}} Please match the e-mail address above {{errorMessages.TGEMAIL.pattern}} {{errorMessages.TGEMAIL.pattern}} {{errorMessages.TGEMAIL}} {{errorMessages.TGEMAIL.pattern}}
{{errorMessages.TGPHONECountry.required}} {{errorMessages.TGPHONECountry}}
{{errorMessages.TGPHONEPhone.required}} {{errorMessages.TGPHONEPhone.pattern}} {{errorMessages.TGPHONEPhone.pattern}} {{errorMessages.TGPHONEPhone.pattern}} {{errorMessages.TGPHONEPhone}} {{errorMessages.TGPHONEPhone.pattern}}

My full address

{{errorMessages.TGzip.required}} {{errorMessages.TGzip.pattern}} {{errorMessages.TGzip.pattern}} {{errorMessages.TGzip.pattern}} {{errorMessages.TGzip}} {{errorMessages.TGzip.pattern}}
{{errorMessages.TGcityName.required}} {{errorMessages.TGcityName.pattern}} {{errorMessages.TGcityName.pattern}} {{errorMessages.TGcityName.pattern}} {{errorMessages.TGcityName}} {{errorMessages.TGcityName.pattern}}
{{errorMessages.TGstreetName.required}} {{errorMessages.TGstreetName.pattern}} {{errorMessages.TGstreetName.pattern}} {{errorMessages.TGstreetName.pattern}} {{errorMessages.TGstreetName}} {{errorMessages.TGstreetName.pattern}}
{{errorMessages.TGhouseNumber.required}} {{errorMessages.TGhouseNumber.pattern}} {{errorMessages.TGhouseNumber.pattern}} {{errorMessages.TGhouseNumber.pattern}} {{errorMessages.TGhouseNumber}} {{errorMessages.TGhouseNumber.pattern}}
I would like to change my contact details for this request
{{errorMessages.updateTGContactDetails.required}}
{{errorMessages.CONTACTTGFIRSTNAME.required}} {{errorMessages.CONTACTTGFIRSTNAME.pattern}} {{errorMessages.CONTACTTGFIRSTNAME.pattern}} {{errorMessages.CONTACTTGFIRSTNAME.pattern}} {{errorMessages.CONTACTTGFIRSTNAME}} {{errorMessages.CONTACTTGFIRSTNAME.pattern}}
{{errorMessages.CONTACTTGLASTNAME.required}} {{errorMessages.CONTACTTGLASTNAME.pattern}} {{errorMessages.CONTACTTGLASTNAME.pattern}} {{errorMessages.CONTACTTGLASTNAME.pattern}} {{errorMessages.CONTACTTGLASTNAME}} {{errorMessages.CONTACTTGLASTNAME.pattern}}
{{errorMessages.CONTACTTGEMAIL.required}} {{errorMessages.CONTACTTGEMAIL.pattern}} Please match the e-mail address above {{errorMessages.CONTACTTGEMAIL.pattern}} {{errorMessages.CONTACTTGEMAIL.pattern}} {{errorMessages.CONTACTTGEMAIL}} {{errorMessages.CONTACTTGEMAIL.pattern}}
{{errorMessages.CONTACTTGPHONECountry.required}} {{errorMessages.CONTACTTGPHONECountry}}
{{errorMessages.CONTACTTGPHONEPhone.required}} {{errorMessages.CONTACTTGPHONEPhone.pattern}} {{errorMessages.CONTACTTGPHONEPhone.pattern}} {{errorMessages.CONTACTTGPHONEPhone.pattern}} {{errorMessages.CONTACTTGPHONEPhone}} {{errorMessages.CONTACTTGPHONEPhone.pattern}}

Subscriptions to transfer

Select the subscriptions you wish to take over
{{errorMessages.mobile.required}}
e.g. 012345678,123456789123 {{errorMessages.FIXCLE.required}} {{errorMessages.FIXCLE.pattern}} {{errorMessages.FIXCLE.pattern}} {{errorMessages.FIXCLE.pattern}} {{errorMessages.FIXCLE}} {{errorMessages.FIXCLE.pattern}}
e.g. 0412345678,0423456789 {{errorMessages.MOBCLE.required}} {{errorMessages.MOBCLE.pattern}} {{errorMessages.MOBCLE.pattern}} {{errorMessages.MOBCLE.pattern}} {{errorMessages.MOBCLE}} {{errorMessages.MOBCLE.pattern}}

Joint offer - good to know

You can keep all devices that have been handed over to the deceased when the contract was concluded, like smartphones or TVs. The residual value does not need to be paid for. More information in the confirmation email.

Domiciliation

With direct debit, your monthly bills are paid automatically. So you avoid reminders, extra charges, or service interruptions

I wish to activate direct debit
{{errorMessages.INVOICELC.required}}
{{errorMessages.TGIBAN.required}} {{errorMessages.TGIBAN.pattern}} {{errorMessages.TGIBAN.pattern}} {{errorMessages.TGIBAN.pattern}} {{errorMessages.TGIBAN}} {{errorMessages.TGIBAN.pattern}}
{{errorMessages.INVOICECH.required}} {{errorMessages.INVOICECH.pattern}}
I would like to change my contact details for billing communication
{{errorMessages.updateTGBillingDetails.required}}
{{errorMessages.BILLINGTGCUSTOMERID.required}} {{errorMessages.BILLINGTGCUSTOMERID.pattern}} {{errorMessages.BILLINGTGCUSTOMERID.pattern}} {{errorMessages.BILLINGTGCUSTOMERID.pattern}} {{errorMessages.BILLINGTGCUSTOMERID}} {{errorMessages.BILLINGTGCUSTOMERID.pattern}}
{{errorMessages.BILLINGTGFIRSTNAME.required}} {{errorMessages.BILLINGTGFIRSTNAME.pattern}} {{errorMessages.BILLINGTGFIRSTNAME.pattern}} {{errorMessages.BILLINGTGFIRSTNAME.pattern}} {{errorMessages.BILLINGTGFIRSTNAME}} {{errorMessages.BILLINGTGFIRSTNAME.pattern}}
{{errorMessages.BILLINGTGLASTNAME.required}} {{errorMessages.BILLINGTGLASTNAME.pattern}} {{errorMessages.BILLINGTGLASTNAME.pattern}} {{errorMessages.BILLINGTGLASTNAME.pattern}} {{errorMessages.BILLINGTGLASTNAME}} {{errorMessages.BILLINGTGLASTNAME.pattern}}
{{errorMessages.BILLINGTGEMAIL.required}} {{errorMessages.BILLINGTGEMAIL.pattern}} Please match the e-mail address above {{errorMessages.BILLINGTGEMAIL.pattern}} {{errorMessages.BILLINGTGEMAIL.pattern}} {{errorMessages.BILLINGTGEMAIL}} {{errorMessages.BILLINGTGEMAIL.pattern}}
{{errorMessages.BILLINGTGPHONECountry.required}} {{errorMessages.BILLINGTGPHONECountry}}
{{errorMessages.BILLINGTGPHONEPhone.required}} {{errorMessages.BILLINGTGPHONEPhone.pattern}} {{errorMessages.BILLINGTGPHONEPhone.pattern}} {{errorMessages.BILLINGTGPHONEPhone.pattern}} {{errorMessages.BILLINGTGPHONEPhone}} {{errorMessages.BILLINGTGPHONEPhone.pattern}}
{{errorMessages.COREQAPPROVAL.required}} {{errorMessages.COREQAPPROVAL.pattern}}
{{errorMessages.LEGALNOTICE.required}} {{errorMessages.LEGALNOTICE.pattern}}

You can find those general terms and conditions here

Telephone directories and directory assistance services
{{errorMessages.FREELISTING.required}}
{{errorMessages.SEARCHNAME_ADDR.required}} {{errorMessages.SEARCHNAME_ADDR.pattern}}

You can change your preferences and directory details in MyProximus at any time. Your data will be processed in accordance with our privacy policy

Summary

Your data


{{step.title}}
  • {{field.title}} :
    Yes No {{hasProperty(field.name,model[field.name])}}
    Slot :
    {{convertToDisplay(model[field.name])}}
    Slot :
    {{model[field.name]}}
    {{field.title}} :
    {{model[field.name].fuzzySearch}}
    {{field.title}} :
    {{model[field.name].streetName}} {{model[field.name].houseNumber}} {{model[field.name].houseNumberSuffix + ','}} {{model[field.name].zipCode}} {{model[field.name].cityName}}

By filling in this form you are providing Proximus with your personal data. Proximus, as data controller, process your data solely for the purpose of contacting you for follow-up communications and based on its legitimate interest of facilitating the cease of the products of the concerned customer. We will not contact you for promotional purposes.

Proximus will keep your data for a period of 14 months after their collection.

You can access your data, rectify it, request its deletion or exercise your right to limit the processing of your data. To exercise your rights, you can contact the Proximus Data Protection Office, either by e-mail at privacy@proximus.com, or via this web form, or by post at Boulevard du Roi Albert II, 27, 1030 Brussels. To learn more about how Proximus process your personal data and how to exercise your rights, please consult our privacy policy.

In accordance with Article 77 GDPR, you also have the right to lodge a complaint with the Belgian Data Protection Authority.

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