CSD_BE_FormDigi | Worldline Global

* Mandatory fields

Request type

Your first name *

Your last name *

Your email address *

Number of requested digipasses *

Please note that a cost of € 98,28 per digipass will be charged.
The price VAT excluded.

VAT number *

Your reference number (P.O.) - optional

Phone number (busines shours) *

Sent the digipasses and the init-pins to the same address? *

Yes No

Delivery address digipass *

Delivery address documents and init-pins

Validation

Charges can apply for the order of digipasses. Do you agree with the additional charges? *

I agree