Inscripción

Welcome to the Direct-debits registration form

Following registration, you will be able to test the Direct-debits program for 60 days, free of charge.
At any time during this period, you can choose to complete your registration and subscribe to the service by printing out the subscription contract.

Feel free to contact us

by email: assistance@exalog.com

or by telephone: +33 1 81 89 00 81

* Mandatory fields

Descripción de la organización

Razón social* :

Dirección* :

Código postal* :

Ciudad :

País* :

Administrador (usuario con todos los derechos)

Enter the person appointed as administrator, i.e. the person with the right to access all the functions and data.
You can then set up other users.

Tratamiento* :

Apellido* :

Nombre :

Choose an access name* :

Teléfono :

Email* :

How have you heard of
direct-debitss* :

He leído y estoy de acuerdo con el conditions of use