my-mister-portal.net
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85.214.24.225
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Submitted URL: https://energie.mrcn.de/
Effective URL: https://my-mister-portal.net/items-share/375/1256?view=1
Submission: On July 09 via api from US — Scanned from DE
Effective URL: https://my-mister-portal.net/items-share/375/1256?view=1
Submission: On July 09 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST
<form class="form" method="post" novalidate="novalidate">
<input type="hidden" name="_token" value="pCgIKP0xJ3WlML0O1YHL56SNzCmykl8ntI3pLIhp"> <input type="hidden" name="provider_id" value="1150">
<input type="hidden" name="portal" value="2">
<input type="hidden" name="price" value="">
<input type="hidden" name="type" value="share">
<input type="hidden" name="product_id" value="375">
<input type="hidden" name="product_variation" value="">
<input type="hidden" name="user_id" value="1256">
<input type="hidden" name="create_user_id" value="1256">
<input type="hidden" name="status" value="1">
<input type="hidden" name="kunde" value="new">
<input type="hidden" name="share" value="1">
<div class="card-body ert" style=" padding-bottom: 0;">
<div class="row">
<div class="col-lg-9">
<h4>
<span style="margin-right: 5px;" class="navi-icon"><i class="flaticon-users"></i></span>.Mercan + Wriede GbR <span style=" margin-right: 5px; margin-left: 15px;" class="navi-icon"><i class="flaticon-users"></i></span>Ali Haydar Mercan
<span style=" margin-right: 5px; margin-left: 15px;" class="navi-icon"><i class="flaticon-whatsapp"></i></span> 015167108686 <span style=" margin-right: 5px; margin-left: 15px;"
class="navi-icon"><i class="flaticon-email"></i></span> kontakt@mw-digital.net
</h4>
<h4>Energieoptimierung Privat</h4>
</div>
<div class="col-lg-3">
<h4 style="text-align: right;"><a target="_blank" href="https://www.vertrieb-mister-energy.net/fileadmin/user_upload/Einwilligung_DSGVO_My_Mister.pdf">Zum Download DSGVO</a></h4>
</div>
</div>
<br><br>
<div class="kund">
<div class="form-group row">
<div class="col-lg-4">
<label>Anrede*</label>
<select class="form-control form-control-solid select2 select2-hidden-accessible" name="anrede" required="" data-select2-id="1" tabindex="-1" aria-hidden="true">
<option value="Herr" data-select2-id="3">Herr</option>
<option value="Frau">Frau</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="2" style="width: 393.828px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-anrede-p9-container"><span class="select2-selection__rendered" id="select2-anrede-p9-container" role="textbox" aria-readonly="true"
title="Herr">Herr</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<div class="col-lg-4">
<label>Vorname*:</label>
<input type="text" name="first_name" class="form-control form-control-solid" placeholder="Enter full name" required="">
</div>
<div class="col-lg-4">
<label>Nachname*</label>
<input type="text" name="last_name" class="form-control form-control-solid" placeholder="Enter full name" required="">
</div>
<div class="col-lg-4">
<label> Telefon*</label>
<input type="text" name="phone" class="form-control form-control-solid" placeholder="" required="">
</div>
<div class="col-lg-4">
<label>E-Mail*</label>
<input type="email" name="email" class="form-control form-control-solid" placeholder="" required="">
</div>
<div class="col-lg-4">
<label>Firma</label>
<input type="text" name="company" class="form-control form-control-solid" placeholder="">
</div>
<div class="col-lg-12 full-addr">
<label>vollständige Adresse. Bitte ohne Komma. (hintereinander) Postleitzahl Stadt Straße Hausnummer</label>
<input name="location" class="form-control form-control-solid pac-target-input" id="autocomplete" placeholder="Kundenadresse eingeben" onfocus="geolocate()" type="text" autocomplete="off">
</div>
<div class="col-lg-4">
<label>Stadt*</label>
<input type="text" id="locality" name="city" class="form-control form-control-solid" placeholder="" required="">
</div>
<div class="col-lg-4">
<label>Straße*</label>
<input type="text" id="route" name="street" class="form-control form-control-solid" placeholder="" required="">
</div>
<div class="col-lg-4">
<label>Hausnummer*</label>
<input type="text" id="street_number" name="number" class="form-control form-control-solid" placeholder="" required="">
</div>
<div class="col-lg-4">
<label> Postleitzahl*</label>
<input type="text" id="postal_code" name="zip" class="form-control form-control-solid" placeholder="" required="">
</div>
<div class="col-lg-4">
<label>Geburtsdatum (Bitte im Format JJJJ-MM-TT)*</label>
<input type="date" name="birthday" class="datepicker- form-control form-control-solid" placeholder="" required="">
</div>
<div class="col-lg-12">
<label>Abweichende Anschrift</label>
<div class="radio-inline add_addr">
<label class="radio radio-primary">
<input class="no" type="radio" value="1" name="ac" checked=""checked"">
<span></span>Nein</label>
<label class="radio radio-primary">
<input class="yes" type="radio" value="2" name="ac">
<span></span>Ja</label>
</div>
</div>
</div>
<div class="form-group row add_address" style="display: none;">
<div class="col-lg-12" style="margin-bottom: 0">
<h3 class="font-size-lg text-dark font-weight-bold mb-6">Rechnungsadresse ist abweichend</h3>
</div>
<div class="col-lg-4">
<label>Stadt</label>
<input type="text" id="locality_a" name="city_a" class="form-control form-control-solid" placeholder="">
</div>
<div class="col-lg-4">
<label>Straße</label>
<input type="text" id="route_a" name="street_a" class="form-control form-control-solid" placeholder="">
</div>
<div class="col-lg-4">
<label>Hausnummer</label>
<input type="text" id="street_number_a" name="number_a" class="form-control form-control-solid" placeholder="">
</div>
<div class="col-lg-4">
<label> Postleitzahl</label>
<input type="text" id="postal_code_a" name="zip_a" class="form-control form-control-solid" placeholder="">
</div>
</div>
<div class="banking" style="display: none">
<h3 class="font-size-lg text-dark font-weight-bold mb-6">Bankverbindung</h3>
<div class="form-group row">
<div class="col-lg-4">
<label>IBAN</label>
<input type="text" name="iban" class="form-control form-control-solid" placeholder="">
</div>
<div class="col-lg-4">
<label>BIC</label>
<input type="text" name="bic" class="form-control form-control-solid" placeholder="">
</div>
</div>
</div>
<div class="file-order">
<label class="checkbox checkbox-single">
<input type="checkbox" value="1" name="dsgvo" required="required"> <span></span>
<p style="margin-bottom: 0;
padding-left: 10px;">Einwilligungserklärung DSGVO My-Mister gelesen und akzeptiert (Zum Download DSGVO oben rechts)</p>
</label>
</div>
</div>
<br><br>
<div class="custom-fields-o">
<h3 class="font-size-lg text-dark font-weight-bold mb-6">Energie privat</h3>
<div class="form-group row addon-f">
<div class="col-lg-4 f-cs" data-else="" style=" ">
<label class="add-cf">Handelt es sich um einen Vertragswechsel oder um einen Neueinzug?</label>
<select class="form-control form-control-solid select2 select2-hidden-accessible" name="424" required="" data-select2-id="4" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="6"></option>
<option value="Vertragswechsel">Vertragswechsel</option>
<option value="Neueinzug">Neueinzug</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="5" style="width: 393.828px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-424-95-container"><span class="select2-selection__rendered" id="select2-424-95-container" role="textbox" aria-readonly="true"><span
class="select2-selection__placeholder">bitte auswählen</span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
<div class="col-lg-4 " data-else="424=Neueinzug" style="display:none ">
<label class="add-cf">Handelt es sich um Strom oder Gas?</label>
<select class="form-control form-control-solid select2 ignore select2-hidden-accessible" name="436" required="" data-select2-id="7" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="9"></option>
<option value="Strom">Strom</option>
<option value="Gas">Gas</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="8" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-436-x5-container"><span class="select2-selection__rendered" id="select2-436-x5-container" role="textbox" aria-readonly="true"><span
class="select2-selection__placeholder">bitte auswählen</span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
<div class="col-lg-4 " data-else="436=Strom" style="display:none ">
<label class="add-cf">Wie hoch ist der Strom-Verbrauch in kWh ?</label>
<input type="text" name="c_wie_hoch_ist_der_strom_verbrauch" class="form-control form-control-solid ignore" placeholder="" required="">
</div>
<div class="col-lg-4 " data-else="436=Strom" style="display:none ">
<label class="add-cf">Zählernummer Strom</label>
<input type="text" name="c_zahlernummer_strom" class="form-control form-control-solid ignore" placeholder="" required="">
</div>
<div class="col-lg-4 " data-else="436=Strom" style="display:none ">
<label class="add-cf">Wenn vorhanden senden Sie uns bitte hier ein Foto vom Strom-Zähler</label>
<div class="uppy" id="kt_uppy_10">
<input type="hidden" name="c_wenn_vorhanden_senden_sie_uns_bitte_hier_ein_foto_vom_strom_zahler" class="v_id form-control form-control-solid ignore" placeholder="">
<div class="uppy-wrapper">
<div class="uppy-Root uppy-FileInput-container"><input class="uppy-FileInput-input uppy-input-control" type="file" name="files[]" multiple="" accept="image/*,.pdf" id="kt_uppy_10_input_control" style=""><label
class="uppy-input-label btn btn-light-primary btn-sm btn-bold" for="kt_uppy_10_input_control">Datei hochladen</label></div>
</div>
<div class="uppy-list"></div>
<div class="uppy-status">
<div class="uppy-Root uppy-StatusBar is-waiting" aria-hidden="true">
<div class="uppy-StatusBar-progress
" role="progressbar" aria-valuemin="0" aria-valuemax="100" aria-valuenow="0" style="width: 0%;"></div>
<div class="uppy-StatusBar-actions"></div>
</div>
</div>
<div class="uppy-informer uppy-informer-min">
<div class="uppy uppy-Informer" aria-hidden="true">
<p role="alert"> </p>
</div>
</div>
</div>
<span class="form-text text-muted">Max file size is 100MB.</span>
</div>
<div class="col-lg-4 " data-else="436=Strom" style="display:none ">
<label class="add-cf">Wenn vorhanden senden Sie uns bitte hier ein Übergabeprotokoll</label>
<div class="uppy" id="kt_uppy_11">
<input type="hidden" name="c_wenn_vorhanden_senden_sie_uns_bitte_hier_ein_ubergabeprotokoll" class="v_id form-control form-control-solid ignore" placeholder="">
<div class="uppy-wrapper">
<div class="uppy-Root uppy-FileInput-container"><input class="uppy-FileInput-input uppy-input-control" type="file" name="files[]" multiple="" accept="image/*,.pdf" id="kt_uppy_11_input_control" style=""><label
class="uppy-input-label btn btn-light-primary btn-sm btn-bold" for="kt_uppy_11_input_control">Datei hochladen</label></div>
</div>
<div class="uppy-list"></div>
<div class="uppy-status">
<div class="uppy-Root uppy-StatusBar is-waiting" aria-hidden="true">
<div class="uppy-StatusBar-progress
" role="progressbar" aria-valuemin="0" aria-valuemax="100" aria-valuenow="0" style="width: 0%;"></div>
<div class="uppy-StatusBar-actions"></div>
</div>
</div>
<div class="uppy-informer uppy-informer-min">
<div class="uppy uppy-Informer" aria-hidden="true">
<p role="alert"> </p>
</div>
</div>
</div>
<span class="form-text text-muted">Max file size is 100MB.</span>
</div>
<div class="col-lg-4 " data-else="436=Gas" style="display:none ">
<label class="add-cf">Wie hoch ist der Gas-Verbrauch in kWh</label>
<input type="text" name="c_wie_hoch_ist_der_gas_verbrauch_in_kwh" class="form-control form-control-solid ignore" placeholder="" required="">
</div>
<div class="col-lg-4 " data-else="436=Gas" style="display:none ">
<label class="add-cf">Zählernummer Gas</label>
<input type="text" name="c_zahlernummer_gas" class="form-control form-control-solid ignore" placeholder="" required="">
</div>
<div class="col-lg-4 " data-else="436=Gas" style="display:none ">
<label class="add-cf">Wenn vorhanden senden Sie uns bitte hier ein Foto vom Gas-Zähler</label>
<div class="uppy" id="kt_uppy_12">
<input type="hidden" name="c_wenn_vorhanden_senden_sie_uns_bitte_hier_ein_foto_vom_gas_zahler" class="v_id form-control form-control-solid ignore" placeholder="">
<div class="uppy-wrapper">
<div class="uppy-Root uppy-FileInput-container"><input class="uppy-FileInput-input uppy-input-control" type="file" name="files[]" multiple="" accept="image/*,.pdf" id="kt_uppy_12_input_control" style=""><label
class="uppy-input-label btn btn-light-primary btn-sm btn-bold" for="kt_uppy_12_input_control">Datei hochladen</label></div>
</div>
<div class="uppy-list"></div>
<div class="uppy-status">
<div class="uppy-Root uppy-StatusBar is-waiting" aria-hidden="true">
<div class="uppy-StatusBar-progress
" role="progressbar" aria-valuemin="0" aria-valuemax="100" aria-valuenow="0" style="width: 0%;"></div>
<div class="uppy-StatusBar-actions"></div>
</div>
</div>
<div class="uppy-informer uppy-informer-min">
<div class="uppy uppy-Informer" aria-hidden="true">
<p role="alert"> </p>
</div>
</div>
</div>
<span class="form-text text-muted">Max file size is 100MB.</span>
</div>
<div class="col-lg-4 " data-else="436=Gas" style="display:none ">
<label class="add-cf">Wenn vorhanden senden Sie uns bitte hier ein Übergabeprotokoll</label>
<div class="uppy" id="kt_uppy_13">
<input type="hidden" name="c_wenn_vorhanden_senden_sie_uns_bitte_hier_ein_ubergabeprotokoll" class="v_id form-control form-control-solid ignore" placeholder="">
<div class="uppy-wrapper">
<div class="uppy-Root uppy-FileInput-container"><input class="uppy-FileInput-input uppy-input-control" type="file" name="files[]" multiple="" accept="image/*,.pdf" id="kt_uppy_13_input_control" style=""><label
class="uppy-input-label btn btn-light-primary btn-sm btn-bold" for="kt_uppy_13_input_control">Datei hochladen</label></div>
</div>
<div class="uppy-list"></div>
<div class="uppy-status">
<div class="uppy-Root uppy-StatusBar is-waiting" aria-hidden="true">
<div class="uppy-StatusBar-progress
" role="progressbar" aria-valuemin="0" aria-valuemax="100" aria-valuenow="0" style="width: 0%;"></div>
<div class="uppy-StatusBar-actions"></div>
</div>
</div>
<div class="uppy-informer uppy-informer-min">
<div class="uppy uppy-Informer" aria-hidden="true">
<p role="alert"> </p>
</div>
</div>
</div>
<span class="form-text text-muted">Max file size is 100MB.</span>
</div>
<div class="col-lg-4 " data-else="436=Strom" style="display:none ">
<label class="add-cf">Wünschen Sie Öko-Strom?</label>
<select class="form-control form-control-solid select2 ignore select2-hidden-accessible" name="445" required="" data-select2-id="10" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="12"></option>
<option value="Ja">Ja</option>
<option value="Nein">Nein</option>
<option value="Egal">Egal</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="11" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-445-tn-container"><span class="select2-selection__rendered" id="select2-445-tn-container" role="textbox" aria-readonly="true"><span
class="select2-selection__placeholder">bitte auswählen</span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
<div class="col-lg-4 " data-else="424=Vertragswechsel" style="display:none ">
<label class="add-cf">Handelt es sich um Strom oder Gas?</label>
<select class="form-control form-control-solid select2 ignore select2-hidden-accessible" name="446" required="" data-select2-id="13" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="15"></option>
<option value="Strom">Strom</option>
<option value="Gas">Gas</option>
<option value=""></option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="14" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-446-sg-container"><span class="select2-selection__rendered" id="select2-446-sg-container" role="textbox" aria-readonly="true"><span
class="select2-selection__placeholder">bitte auswählen</span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
<div class="col-lg-4 " data-else="446=Strom" style="display:none ">
<label class="add-cf">Bitte laden Sie hier die letzte Stromabrechnung hoch</label>
<div class="uppy" id="kt_uppy_14">
<input type="hidden" name="c_bitte_laden_sie_hier_die_letzte_stromabrechnung_hoch" class="v_id form-control form-control-solid ignore" placeholder="" required="">
<div class="uppy-wrapper">
<div class="uppy-Root uppy-FileInput-container"><input class="uppy-FileInput-input uppy-input-control" type="file" name="files[]" multiple="" accept="image/*,.pdf" id="kt_uppy_14_input_control" style=""><label
class="uppy-input-label btn btn-light-primary btn-sm btn-bold" for="kt_uppy_14_input_control">Datei hochladen</label></div>
</div>
<div class="uppy-list"></div>
<div class="uppy-status">
<div class="uppy-Root uppy-StatusBar is-waiting" aria-hidden="true">
<div class="uppy-StatusBar-progress
" role="progressbar" aria-valuemin="0" aria-valuemax="100" aria-valuenow="0" style="width: 0%;"></div>
<div class="uppy-StatusBar-actions"></div>
</div>
</div>
<div class="uppy-informer uppy-informer-min">
<div class="uppy uppy-Informer" aria-hidden="true">
<p role="alert"> </p>
</div>
</div>
</div>
<span class="form-text text-muted">Max file size is 100MB.</span>
</div>
<div class="col-lg-4 " data-else="446=Strom" style="display:none ">
<label class="add-cf">Wie hoch war der Strom-Vorjahresverbrauch Strom in kWh?</label>
<input type="text" name="c_wie_hoch_war_der_strom_vorjahresverbrauch_strom_in_kwh" class="form-control form-control-solid ignore" placeholder="" required="">
</div>
<div class="col-lg-4 " data-else="446=Strom" style="display:none ">
<label class="add-cf">Wünschen Sie Öko-Strom?</label>
<select class="form-control form-control-solid select2 ignore select2-hidden-accessible" name="449" required="" data-select2-id="16" tabindex="-1" aria-hidden="true">
<option value="" data-select2-id="18"></option>
<option value="Ja">Ja</option>
<option value="Nein">Nein</option>
<option value="Egal">Egal</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="17" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-449-2r-container"><span class="select2-selection__rendered" id="select2-449-2r-container" role="textbox" aria-readonly="true"><span
class="select2-selection__placeholder">bitte auswählen</span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
aria-hidden="true"></span></span>
</div>
<div class="col-lg-4 " data-else="446=Gas" style="display:none ">
<label class="add-cf">Bitte laden Sie hier die letzte Gasabrechnung hoch</label>
<div class="uppy" id="kt_uppy_15">
<input type="hidden" name="c_bitte_laden_sie_hier_die_letzte_gasabrechnung_hoch" class="v_id form-control form-control-solid ignore" placeholder="" required="">
<div class="uppy-wrapper">
<div class="uppy-Root uppy-FileInput-container"><input class="uppy-FileInput-input uppy-input-control" type="file" name="files[]" multiple="" accept="image/*,.pdf" id="kt_uppy_15_input_control" style=""><label
class="uppy-input-label btn btn-light-primary btn-sm btn-bold" for="kt_uppy_15_input_control">Datei hochladen</label></div>
</div>
<div class="uppy-list"></div>
<div class="uppy-status">
<div class="uppy-Root uppy-StatusBar is-waiting" aria-hidden="true">
<div class="uppy-StatusBar-progress
" role="progressbar" aria-valuemin="0" aria-valuemax="100" aria-valuenow="0" style="width: 0%;"></div>
<div class="uppy-StatusBar-actions"></div>
</div>
</div>
<div class="uppy-informer uppy-informer-min">
<div class="uppy uppy-Informer" aria-hidden="true">
<p role="alert"> </p>
</div>
</div>
</div>
<span class="form-text text-muted">Max file size is 100MB.</span>
</div>
<div class="col-lg-4 " data-else="446=Gas" style="display:none ">
<label class="add-cf">Wie hoch war der Gas-Vorjahresverbrauch Gas in kWh?</label>
<div class="uppy" id="kt_uppy_16">
<input type="hidden" name="c_wie_hoch_war_der_gas_vorjahresverbrauch_gas_in_kwh" class="v_id form-control form-control-solid ignore" placeholder="" required="">
<div class="uppy-wrapper">
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.MERCAN + WRIEDE GBR ALI HAYDAR MERCAN 015167108686 KONTAKT@MW-DIGITAL.NET ENERGIEOPTIMIERUNG PRIVAT ZUM DOWNLOAD DSGVO Anrede* Herr Frau Herr Vorname*: Nachname* Telefon* E-Mail* Firma vollständige Adresse. Bitte ohne Komma. (hintereinander) Postleitzahl Stadt Straße Hausnummer Stadt* Straße* Hausnummer* Postleitzahl* Geburtsdatum (Bitte im Format JJJJ-MM-TT)* Abweichende Anschrift Nein Ja RECHNUNGSADRESSE IST ABWEICHEND Stadt Straße Hausnummer Postleitzahl BANKVERBINDUNG IBAN BIC Einwilligungserklärung DSGVO My-Mister gelesen und akzeptiert (Zum Download DSGVO oben rechts) ENERGIE PRIVAT Handelt es sich um einen Vertragswechsel oder um einen Neueinzug? Vertragswechsel Neueinzug bitte auswählen Handelt es sich um Strom oder Gas? Strom Gas bitte auswählen Wie hoch ist der Strom-Verbrauch in kWh ? Zählernummer Strom Wenn vorhanden senden Sie uns bitte hier ein Foto vom Strom-Zähler Datei hochladen Max file size is 100MB. Wenn vorhanden senden Sie uns bitte hier ein Übergabeprotokoll Datei hochladen Max file size is 100MB. Wie hoch ist der Gas-Verbrauch in kWh Zählernummer Gas Wenn vorhanden senden Sie uns bitte hier ein Foto vom Gas-Zähler Datei hochladen Max file size is 100MB. Wenn vorhanden senden Sie uns bitte hier ein Übergabeprotokoll Datei hochladen Max file size is 100MB. Wünschen Sie Öko-Strom? Ja Nein Egal bitte auswählen Handelt es sich um Strom oder Gas? Strom Gas bitte auswählen Bitte laden Sie hier die letzte Stromabrechnung hoch Datei hochladen Max file size is 100MB. Wie hoch war der Strom-Vorjahresverbrauch Strom in kWh? Wünschen Sie Öko-Strom? Ja Nein Egal bitte auswählen Bitte laden Sie hier die letzte Gasabrechnung hoch Datei hochladen Max file size is 100MB. Wie hoch war der Gas-Vorjahresverbrauch Gas in kWh? Datei hochladen Max file size is 100MB. IBAN ( Wird nach Angebotsannahme zur Vertragserstellung benötigt ) Weitere Informationen ? Wie möchte ich den Antrag erhalten? Digitale Online Unterschrift PDF Antrag per Mail bitte auswählen Hiermit bestätige ich die kontaktlosen/ Digitale Online - Unterschrift und willige ein, das mir der Link via SMS oder Email ( Je nach Anbieter ) zugesandt werden darf. Meine Kontaktdaten dürfen hierzu benutzt werden! Ja bitte auswählen Weitere Schreiben Datei hochladen Max file size is 100MB. Einzugsdatum Zählernummer Um was für ein Strom handelt es sich Normaler Haushaltsstrom Wärmepumpe Nachtspeicherheizung bitte auswählen Um was für ein Strom handelt es sich Normaler Haushaltsstrom Wärmepumpe Nachtspeicherheizung bitte auswählen Verbrauch Wärmepumpe HT: Verbrauch Nachtspeicher HT: Verbrauch Nachtspeicher HT: Verbrauch Nachtspeicher NT:: Verbrauch Nachtspeicher NT: Verbrauch Wärmepumpe NT: Erstellen 2022 © My Mister