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All form fields are required.

Details from this form are necessary in order to announce your payment to
our accounting department upon successful payment.

The field amount to be paid is assigned by you and must contain the amount
to be paid for one or several documents, the numbers or codes of which
correspond to the field "References" ("References to documents")

The "References" field must contain one or several numbers or codes
of documents issued by us, separated by commas.

Additionally, you can describe the payment in the comment field.

After filling out the form, you will be directed to our partner Ingenico.com
to the pages for immediate posting with your card.

The payment in our favor will be made in euros (euro is our domestic currency).
This will lead to some costs on your part, attribute them to the cost of currency conversion.
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References to documents*

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公司名称*

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附有 (*) 的部分为阁下必须填写的资料。





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