付款证明, 款到开通服务 Betaling Bevestiging, Payment Confirmation

网上用姓名Name In Web "www.teleboxz.com":

自定两位个性数字(此数字要同您的付款的零头一致,以便同其他顾客区分)self made unique number:
(U voegt paar cent meer aan uw betaling bedrag dezelfde is als uw uniek nummer).

您的寄出银行名称 Naam Van Uw Begunstigd Bank:(From which bank):

寄往银行名称 Naar Welke Bank:(To which bank):

汇款日期 年月日 Transaction Date(datum): jjjjmmdd

寄出金额: Bedrag: Amount:

您的经常可以接通的真实电话:Your real telephone number: Uw bereikbaar telefoonnummer:

为了便于查询请您将附加的零头和自定的个性数字一致。Please don't forget to pay a bit more cent (same as your unique number) for distinction.

请选择汇款后主要要求的服务 Welke service wilt u hebben: Which service do you expect to get: