REQUEST for Telephone / Internet connection Private - VEGA-net

VEGA-net GmbH • Hauptstraße 18 • 67677 Enkenbach-Alsenborn
Telefon: 06303. 999 8 999 • Telefax: 06303. 913 198 • [email protected]
www.vega-net.de
Unternehmenssitz: Enkenbach-Alsenborn
Amtsgericht Kaiserslautern • HRB Nr. 30946 • Steuer-Nr.: 19/660/01956
Geschäftsführer: Manuel Steller
Vorsitzender des Aufsichtsrates: Jürgen Wenzel
Bankverbindung: Kreissparkasse Kaiserslautern
BIC: MALADE51KLK und IBAN DE98 5405 0220 0000 5371 00
REQUEST for Telephone / Internet connection
Private customer
Customer
Ms.
Mrs.
Mr.
Last Name
Street / Nr.
Date of Birth
First Name
Zipcode / City
E-Mail
Telephone
Previous telephone connection
I agree with the termination of my existing telephone connection with my current provider and
engage VEGA-net GmbH to forward my termination towards my current provider. As far as I would
like to keep my existing phone number, I instruct VEGA-net GmbH to transfer my existing number.
Previous Provider:
Deutsche Telekom AG
I want a new VEGA-net Phone number
Other:
I want to keep my existing Number
A. Choose your package:
Monthly costs:
Package „MEGA-8“ *
B. Extras
Monthly costs:
Single cost:
Package „MEGA-16“ *
28,95 €
37,95 €
249,00 €**
249,00 €**
Package „MEGA-25“ *
44,95 €
249,00 €
Package „MEGA-50“ *
49,95 €
249,00 €**
-
49,00 €
Upon request:
Junction Box Installation
**
* Monthly cancellation of contract possible. All prices include VAT. We don’t accept VAT-forms.
**
Please see the enclosed declaration. VEGA-net GmbH will absorb the costs for transferring an existing
telephone number. To clarify any further questions I authorize VEGA-net GMBH to make contact with
my current provider.
If you maintain to be our customer for a minimum timespan of 24 months, you will receive
a refund of 150 € after the 24 months.
D. Itemized list of calls
Itemized list of calls online
0,00 €
Itemized list of calls in paper form
2,00 €
Flatrate for the german
conventional telephone
network
VEGA-net
International flat 1 (1
VEGA-net
International flat 2 (1
6,95 €
Monthly costs:
4,95 €
VEGA-mobil, 100 Min. in
all German Cellphone nets
5,50 €
3,95 €
Telephone Book Entry
0,00 €
Bill in paper form
2,00 €
1) Flat for calls to landline.
C. Bill
Online Bill
0,00 €
Confidential Data and the information of my monthly bill can be sent to this EmailAddress:
Total cost monthly:
€
Total cost single payment:
€
E. Other
VEGA-net International flat 1: China, Denmark, France, Greece, Hong Kong, Ireland, Israel, Canada, Croatia, Norway, Portugal, Romania, Sweden, Singapore,
Thailand, Hungary, USA, Cyprus.
VEGA-net International flat 2: Belgium, Bulgaria, Estonia, Faroe Islands, Gibraltar, Great Britain, Italy, Japan, Lithuania, Liechtenstein, Latvia, Luxembourg, Malta,
Monaco, the Netherlands, Austria, Poland, Puerto Rico, San Marino, Switzerland, Slovakia, Slovenia, Spain, Czech Republic, Turkey.
VEGA-net GmbH • Hauptstraße 18 • 67677 Enkenbach-Alsenborn
Telefon: 06303. 999 8 999 • Telefax: 06303. 913 198 • [email protected]
www.vega-net.de
Unternehmenssitz: Enkenbach-Alsenborn
Amtsgericht Kaiserslautern • HRB Nr. 30946 • Steuer-Nr.: 19/660/01956
Geschäftsführer: Manuel Steller
Vorsitzender des Aufsichtsrates: Jürgen Wenzel
Bankverbindung: Kreissparkasse Kaiserslautern
BIC: MALADE51KLK und IBAN DE98 5405 0220 0000 5371 00
SEPA Basic direct debit mandate
Creditor Identification number: DE96ZZZ00000147233
VEGA-net GmbH, Hauptstr. 18, 67677 Enkenbach-Alsenborn
This SEPA Basic direct debit mandate shall apply from signing the contract for Telekommunication- and other Service.
SEPA direct debit mandate:
I / we authorize the payee VEGA-net GmbH to collect payments from my/our account by direct debit. At the same time I / we instruct my / our financial institution to pay the direct debits drawn on my / our account by the payee VEGA-net GmbH. Note: I can request a refund of the debited amount within eight
weeks, beginning on the date of the debit. The conditions agreed with my financial institution shall apply. I am aware that in case of dishonor the bank will
collect reverse entry charges. These costs will be paid by me. In case of dishonor the direct debit authorization will expire.
The Mandatsreferenz shall be notified separately.
Account holder
Name of the bank
Last and first name of the account holder
BIC
(8 or 11 digits)
Street address
DE
Zip Code and town
IBAN
Routing No.
Before the first collection of a SEPA direct debit, the payee
VEGA-net GmbH, will inform me of the collection by this
method.
Place/Date
Signature of the Account holder
Ordering
For credit assessment, I herewith revocable authorize VEGA-net GmbH to exchange data with Schufa and approved credit
agencies, in accordance with subparagraph 2 of our general business terms. Terms and conditions of VEGA-net GmbH
apply to this contract, downloadable on www.vega-net.de. I agree with the use of my personal data in accordance with
subparagraph 12 of our general business terms. In order to ensure better service for my telecommunication system, I allow
VEGA-net to ascertain and use my personal data.
I accept the general business conditions of the VEGA-net GmbH
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Place/Date
Customer’s Signature
Account No.