OF82.95-P-3000-05A | Modification application for SIM card replacement for TELE AID, form |
MODEL 203, 208, 210, 215, 220 with CODE (855) TELE AID
Branch/Agency company no. Customer
Vehicle ident no. Repair order no.
Tester: Name Date
License plate no. Original registration date Model Engine no. Odometer reading: km/miles
Modification application for SIM card replacement for TELE AID
(This form does not apply when owner changes!)
When the SIM card is replaced and the TELE AID service is maintained it is necessary to authorize the removal of the old SIM card for the TELE AID service.Then the new SIM card can be installed and the TELE AID service can be authorized again.
For this purpose fill out bottom fields and send modification application to the CAC.
The fax number of the CAC is: 00 31-4 33 56 23 13
Data for old SIM card
debitel card number __ __ __ __ __ __ __ __ __ __ __ __ __ - __
GSM number 017__ / __ __ __ __ __ __ __
Authorization date __ __.__ __.__ __ (day, month, year)
Data for new SIM card
Card number __ __ __ __ __ __ __ __ __ __ __ __ __ - __
GSM number 017__ / __ __ __ __ __ __ __
Authorization date __ __.__ __.__ __ (day, month, year)
(1 day after
deauthorization date at the earliest)
Stamp of dealer and signature date, customer signature
Name of seller Name of customer