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URL: https://axonaut.com/document/EB2U3LDCJ76QK3BF
Submission: On October 06 via api from BE — Scanned from FR

Form analysis 1 forms found in the DOM

<form class="layoutVertical">
  <div class="formLine">
    <label>Prénom *</label>
    <input class="form-control" id="signatureFirstname" autocomplete="axonautSignFistName">
  </div>
  <div class="formLine">
    <label>Nom *</label>
    <input class="form-control" id="signatureLastname" autocomplete="axonautSignLastName">
  </div>
  <div class="formLine">
    <label>Email *</label>
    <input class="form-control" id="signatureEmail" autocomplete="axonautSignEmail">
  </div>
  <div class="formLine">
    <label>Téléphone portable *</label>
    <small style="line-height: 1.2em; display: inline-block; margin-bottom: 10px;"><i>Un code de confirmation de signature vous sera envoyé par SMS.</i></small>
    <select id="selectPhoneNumberI18N" class="form-control">
      <option value="93"> +93 (Afghanistan) </option>
      <option value="355"> +355 (Albania) </option>
      <option value="213"> +213 (Algeria) </option>
      <option value="-683"> +-683 (American Samoa) </option>
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      <option value="672"> +672 (Antarctica) </option>
      <option value="-267"> +-267 (Antigua and Barbuda) </option>
      <option value="54"> +54 (Argentina) </option>
      <option value="374"> +374 (Armenia) </option>
      <option value="297"> +297 (Aruba) </option>
      <option value="61"> +61 (Australia) </option>
      <option value="43"> +43 (Austria) </option>
      <option value="994"> +994 (Azerbaijan) </option>
      <option value="-241"> +-241 (Bahamas) </option>
      <option value="973"> +973 (Bahrain) </option>
      <option value="880"> +880 (Bangladesh) </option>
      <option value="-245"> +-245 (Barbados) </option>
      <option value="375"> +375 (Belarus) </option>
      <option value="32"> +32 (Belgium) </option>
      <option value="501"> +501 (Belize) </option>
      <option value="229"> +229 (Benin) </option>
      <option value="-440"> +-440 (Bermuda) </option>
      <option value="975"> +975 (Bhutan) </option>
      <option value="591"> +591 (Bolivia) </option>
      <option value="387"> +387 (Bosnia and Herzegovina) </option>
      <option value="267"> +267 (Botswana) </option>
      <option value="55"> +55 (Brazil) </option>
      <option value="246"> +246 (British Indian Ocean Territory) </option>
      <option value="-283"> +-283 (British Virgin Islands) </option>
      <option value="673"> +673 (Brunei) </option>
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      <option value="257"> +257 (Burundi) </option>
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      <option value="1"> +1 (Canada) </option>
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      <option value="236"> +236 (Central African Republic) </option>
      <option value="235"> +235 (Chad) </option>
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      <option value="86"> +86 (China) </option>
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      <option value="251"> +251 (Ethiopia) </option>
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      <option value="358"> +358 (Finland) </option>
      <option value="33" selected=""> +33 (France) </option>
      <option value="689"> +689 (French Polynesia) </option>
      <option value="241"> +241 (Gabon) </option>
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      <option value="995"> +995 (Georgia) </option>
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      <option value="350"> +350 (Gibraltar) </option>
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      <option value="-670"> +-670 (Guam) </option>
      <option value="502"> +502 (Guatemala) </option>
      <option value="-1437"> +-1437 (Guernsey) </option>
      <option value="224"> +224 (Guinea) </option>
      <option value="245"> +245 (Guinea-Bissau) </option>
      <option value="594"> +594 (Guyane Française) </option>
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      <option value="504"> +504 (Honduras) </option>
      <option value="852"> +852 (Hong Kong) </option>
      <option value="36"> +36 (Hungary) </option>
      <option value="354"> +354 (Iceland) </option>
      <option value="91"> +91 (India) </option>
      <option value="62"> +62 (Indonesia) </option>
      <option value="98"> +98 (Iran) </option>
      <option value="964"> +964 (Iraq) </option>
      <option value="353"> +353 (Ireland) </option>
      <option value="-1580"> +-1580 (Isle of Man) </option>
      <option value="972"> +972 (Israel) </option>
      <option value="39"> +39 (Italy) </option>
      <option value="225"> +225 (Ivory Coast) </option>
      <option value="-875"> +-875 (Jamaica) </option>
      <option value="81"> +81 (Japan) </option>
      <option value="-1490"> +-1490 (Jersey) </option>
      <option value="962"> +962 (Jordan) </option>
      <option value="7"> +7 (Kazakhstan) </option>
      <option value="254"> +254 (Kenya) </option>
      <option value="686"> +686 (Kiribati) </option>
      <option value="383"> +383 (Kosovo) </option>
      <option value="965"> +965 (Kuwait) </option>
      <option value="996"> +996 (Kyrgyzstan) </option>
      <option value="856"> +856 (Laos) </option>
      <option value="371"> +371 (Latvia) </option>
      <option value="961"> +961 (Lebanon) </option>
      <option value="266"> +266 (Lesotho) </option>
      <option value="231"> +231 (Liberia) </option>
      <option value="218"> +218 (Libya) </option>
      <option value="423"> +423 (Liechtenstein) </option>
      <option value="370"> +370 (Lithuania) </option>
      <option value="352"> +352 (Luxembourg) </option>
      <option value="853"> +853 (Macau) </option>
      <option value="389"> +389 (Macedonia) </option>
      <option value="261"> +261 (Madagascar) </option>
      <option value="265"> +265 (Malawi) </option>
      <option value="60"> +60 (Malaysia) </option>
      <option value="960"> +960 (Maldives) </option>
      <option value="223"> +223 (Mali) </option>
      <option value="356"> +356 (Malta) </option>
      <option value="692"> +692 (Marshall Islands) </option>
      <option value="596"> +596 (Martinique) </option>
      <option value="222"> +222 (Mauritania) </option>
      <option value="230"> +230 (Mauritius) </option>
      <option value="262"> +262 (Mayotte) </option>
      <option value="52"> +52 (Mexico) </option>
      <option value="691"> +691 (Micronesia) </option>
      <option value="373"> +373 (Moldova) </option>
      <option value="377"> +377 (Monaco) </option>
      <option value="976"> +976 (Mongolia) </option>
      <option value="382"> +382 (Montenegro) </option>
      <option value="-663"> +-663 (Montserrat) </option>
      <option value="212"> +212 (Morocco) </option>
      <option value="258"> +258 (Mozambique) </option>
      <option value="95"> +95 (Myanmar) </option>
      <option value="264"> +264 (Namibia) </option>
      <option value="674"> +674 (Nauru) </option>
      <option value="977"> +977 (Nepal) </option>
      <option value="31"> +31 (Netherlands) </option>
      <option value="599"> +599 (Netherlands Antilles) </option>
      <option value="687"> +687 (New Caledonia) </option>
      <option value="64"> +64 (New Zealand) </option>
      <option value="505"> +505 (Nicaragua) </option>
      <option value="227"> +227 (Niger) </option>
      <option value="234"> +234 (Nigeria) </option>
      <option value="683"> +683 (Niue) </option>
      <option value="850"> +850 (North Korea) </option>
      <option value="-669"> +-669 (Northern Mariana Islands) </option>
      <option value="47"> +47 (Norway) </option>
      <option value="968"> +968 (Oman) </option>
      <option value="92"> +92 (Pakistan) </option>
      <option value="680"> +680 (Palau) </option>
      <option value="970"> +970 (Palestine) </option>
      <option value="507"> +507 (Panama) </option>
      <option value="675"> +675 (Papua New Guinea) </option>
      <option value="595"> +595 (Paraguay) </option>
      <option value="51"> +51 (Peru) </option>
      <option value="63"> +63 (Philippines) </option>
      <option value="64"> +64 (Pitcairn) </option>
      <option value="48"> +48 (Poland) </option>
      <option value="351"> +351 (Portugal) </option>
      <option value="-786"> +-786 (Puerto Rico) </option>
      <option value="974"> +974 (Qatar) </option>
      <option value="242"> +242 (Republic of the Congo) </option>
      <option value="262"> +262 (Reunion) </option>
      <option value="40"> +40 (Romania) </option>
      <option value="7"> +7 (Russia) </option>
      <option value="250"> +250 (Rwanda) </option>
      <option value="590"> +590 (Saint Barthelemy) </option>
      <option value="290"> +290 (Saint Helena) </option>
      <option value="-868"> +-868 (Saint Kitts and Nevis) </option>
      <option value="-757"> +-757 (Saint Lucia) </option>
      <option value="590"> +590 (Saint Martin) </option>
      <option value="508"> +508 (Saint Pierre and Miquelon) </option>
      <option value="-783"> +-783 (Saint Vincent and the Grenadines) </option>
      <option value="685"> +685 (Samoa) </option>
      <option value="378"> +378 (San Marino) </option>
      <option value="239"> +239 (Sao Tome and Principe) </option>
      <option value="966"> +966 (Saudi Arabia) </option>
      <option value="221"> +221 (Senegal) </option>
      <option value="381"> +381 (Serbia) </option>
      <option value="248"> +248 (Seychelles) </option>
      <option value="232"> +232 (Sierra Leone) </option>
      <option value="65"> +65 (Singapore) </option>
      <option value="-720"> +-720 (Sint Maarten) </option>
      <option value="421"> +421 (Slovakia) </option>
      <option value="386"> +386 (Slovenia) </option>
      <option value="677"> +677 (Solomon Islands) </option>
      <option value="252"> +252 (Somalia) </option>
      <option value="27"> +27 (South Africa) </option>
      <option value="82"> +82 (South Korea) </option>
      <option value="211"> +211 (South Sudan) </option>
      <option value="34"> +34 (Spain) </option>
      <option value="94"> +94 (Sri Lanka) </option>
      <option value="249"> +249 (Sudan) </option>
      <option value="597"> +597 (Suriname) </option>
      <option value="47"> +47 (Svalbard and Jan Mayen) </option>
      <option value="268"> +268 (Swaziland) </option>
      <option value="46"> +46 (Sweden) </option>
      <option value="41"> +41 (Switzerland) </option>
      <option value="963"> +963 (Syria) </option>
      <option value="886"> +886 (Taiwan) </option>
      <option value="992"> +992 (Tajikistan) </option>
      <option value="255"> +255 (Tanzania) </option>
      <option value="66"> +66 (Thailand) </option>
      <option value="228"> +228 (Togo) </option>
      <option value="690"> +690 (Tokelau) </option>
      <option value="676"> +676 (Tonga) </option>
      <option value="-867"> +-867 (Trinidad and Tobago) </option>
      <option value="216"> +216 (Tunisia) </option>
      <option value="90"> +90 (Turkey) </option>
      <option value="993"> +993 (Turkmenistan) </option>
      <option value="-648"> +-648 (Turks and Caicos Islands) </option>
      <option value="688"> +688 (Tuvalu) </option>
      <option value="-339"> +-339 (U.S. Virgin Islands) </option>
      <option value="256"> +256 (Uganda) </option>
      <option value="380"> +380 (Ukraine) </option>
      <option value="971"> +971 (United Arab Emirates) </option>
      <option value="44"> +44 (United Kingdom) </option>
      <option value="1"> +1 (United States) </option>
      <option value="598"> +598 (Uruguay) </option>
      <option value="998"> +998 (Uzbekistan) </option>
      <option value="678"> +678 (Vanuatu) </option>
      <option value="379"> +379 (Vatican) </option>
      <option value="58"> +58 (Venezuela) </option>
      <option value="84"> +84 (Vietnam) </option>
      <option value="681"> +681 (Wallis and Futuna) </option>
      <option value="212"> +212 (Western Sahara) </option>
      <option value="967"> +967 (Yemen) </option>
      <option value="260"> +260 (Zambia) </option>
      <option value="263"> +263 (Zimbabwe) </option>
    </select>
    <input class="form-control" id="signaturePhone" autocomplete="axonautSignPhone" value="" placeholder="Téléphone portable">
  </div>
  <div id="coordinatesError" class="alert alert-danger" style="display:none;">Veuillez compléter tous les champs pour continuer.</div>
  <div id="emailError" class="alert alert-danger" style="display:none;">Une erreur est survenue. Veuillez vérifier les coordonnées renseignées.</div>
  <div class="text-center">
    <button type="button" id="btnValid" class="btn btn-block" onclick="avoidMultiClicksFinal($(this)); startProcedure();">
      <i class="axicon_arrow-right" aria-hidden="true"></i> Continuer </button>
  </div>
</form>

Text Content

MARA-A


Voir toutes vos factures
Document mis à jour le 25/09/2024


Signer en ligne

Télécharger le pdf

Comment ça marche ?
"Mon espace client" généré par Axonaut | Générez des factures à votre image

Entrez vos coordonnées pour procéder à la signature électronique

Prénom *
Nom *
Email *
Téléphone portable * Un code de confirmation de signature vous sera envoyé par
SMS. +93 (Afghanistan) +355 (Albania) +213 (Algeria) +-683 (American Samoa) +376
(Andorra) +244 (Angola) +-263 (Anguilla) +672 (Antarctica) +-267 (Antigua and
Barbuda) +54 (Argentina) +374 (Armenia) +297 (Aruba) +61 (Australia) +43
(Austria) +994 (Azerbaijan) +-241 (Bahamas) +973 (Bahrain) +880 (Bangladesh)
+-245 (Barbados) +375 (Belarus) +32 (Belgium) +501 (Belize) +229 (Benin) +-440
(Bermuda) +975 (Bhutan) +591 (Bolivia) +387 (Bosnia and Herzegovina) +267
(Botswana) +55 (Brazil) +246 (British Indian Ocean Territory) +-283 (British
Virgin Islands) +673 (Brunei) +359 (Bulgaria) +226 (Burkina Faso) +257 (Burundi)
+855 (Cambodia) +237 (Cameroon) +1 (Canada) +238 (Cape Verde) +-344 (Cayman
Islands) +236 (Central African Republic) +235 (Chad) +56 (Chile) +86 (China) +61
(Christmas Island) +61 (Cocos Islands) +57 (Colombia) +269 (Comoros) +682 (Cook
Islands) +506 (Costa Rica) +385 (Croatia) +53 (Cuba) +599 (Curacao) +357
(Cyprus) +420 (Czech Republic) +243 (Democratic Republic of the Congo) +45
(Denmark) +253 (Djibouti) +-766 (Dominica) +-808 (Dominican Republic) +670 (East
Timor) +593 (Ecuador) +20 (Egypt) +503 (El Salvador) +240 (Equatorial Guinea)
+291 (Eritrea) +372 (Estonia) +251 (Ethiopia) +500 (Falkland Islands) +298
(Faroe Islands) +679 (Fiji) +358 (Finland) +33 (France) +689 (French Polynesia)
+241 (Gabon) +220 (Gambia) +995 (Georgia) +49 (Germany) +233 (Ghana) +350
(Gibraltar) +30 (Greece) +299 (Greenland) +-472 (Grenada) +590 (Guadeloupe)
+-670 (Guam) +502 (Guatemala) +-1437 (Guernsey) +224 (Guinea) +245
(Guinea-Bissau) +594 (Guyane Française) +592 (Guyana) +509 (Haiti) +504
(Honduras) +852 (Hong Kong) +36 (Hungary) +354 (Iceland) +91 (India) +62
(Indonesia) +98 (Iran) +964 (Iraq) +353 (Ireland) +-1580 (Isle of Man) +972
(Israel) +39 (Italy) +225 (Ivory Coast) +-875 (Jamaica) +81 (Japan) +-1490
(Jersey) +962 (Jordan) +7 (Kazakhstan) +254 (Kenya) +686 (Kiribati) +383
(Kosovo) +965 (Kuwait) +996 (Kyrgyzstan) +856 (Laos) +371 (Latvia) +961
(Lebanon) +266 (Lesotho) +231 (Liberia) +218 (Libya) +423 (Liechtenstein) +370
(Lithuania) +352 (Luxembourg) +853 (Macau) +389 (Macedonia) +261 (Madagascar)
+265 (Malawi) +60 (Malaysia) +960 (Maldives) +223 (Mali) +356 (Malta) +692
(Marshall Islands) +596 (Martinique) +222 (Mauritania) +230 (Mauritius) +262
(Mayotte) +52 (Mexico) +691 (Micronesia) +373 (Moldova) +377 (Monaco) +976
(Mongolia) +382 (Montenegro) +-663 (Montserrat) +212 (Morocco) +258 (Mozambique)
+95 (Myanmar) +264 (Namibia) +674 (Nauru) +977 (Nepal) +31 (Netherlands) +599
(Netherlands Antilles) +687 (New Caledonia) +64 (New Zealand) +505 (Nicaragua)
+227 (Niger) +234 (Nigeria) +683 (Niue) +850 (North Korea) +-669 (Northern
Mariana Islands) +47 (Norway) +968 (Oman) +92 (Pakistan) +680 (Palau) +970
(Palestine) +507 (Panama) +675 (Papua New Guinea) +595 (Paraguay) +51 (Peru) +63
(Philippines) +64 (Pitcairn) +48 (Poland) +351 (Portugal) +-786 (Puerto Rico)
+974 (Qatar) +242 (Republic of the Congo) +262 (Reunion) +40 (Romania) +7
(Russia) +250 (Rwanda) +590 (Saint Barthelemy) +290 (Saint Helena) +-868 (Saint
Kitts and Nevis) +-757 (Saint Lucia) +590 (Saint Martin) +508 (Saint Pierre and
Miquelon) +-783 (Saint Vincent and the Grenadines) +685 (Samoa) +378 (San
Marino) +239 (Sao Tome and Principe) +966 (Saudi Arabia) +221 (Senegal) +381
(Serbia) +248 (Seychelles) +232 (Sierra Leone) +65 (Singapore) +-720 (Sint
Maarten) +421 (Slovakia) +386 (Slovenia) +677 (Solomon Islands) +252 (Somalia)
+27 (South Africa) +82 (South Korea) +211 (South Sudan) +34 (Spain) +94 (Sri
Lanka) +249 (Sudan) +597 (Suriname) +47 (Svalbard and Jan Mayen) +268
(Swaziland) +46 (Sweden) +41 (Switzerland) +963 (Syria) +886 (Taiwan) +992
(Tajikistan) +255 (Tanzania) +66 (Thailand) +228 (Togo) +690 (Tokelau) +676
(Tonga) +-867 (Trinidad and Tobago) +216 (Tunisia) +90 (Turkey) +993
(Turkmenistan) +-648 (Turks and Caicos Islands) +688 (Tuvalu) +-339 (U.S. Virgin
Islands) +256 (Uganda) +380 (Ukraine) +971 (United Arab Emirates) +44 (United
Kingdom) +1 (United States) +598 (Uruguay) +998 (Uzbekistan) +678 (Vanuatu) +379
(Vatican) +58 (Venezuela) +84 (Vietnam) +681 (Wallis and Futuna) +212 (Western
Sahara) +967 (Yemen) +260 (Zambia) +263 (Zimbabwe)
Veuillez compléter tous les champs pour continuer.
Une erreur est survenue. Veuillez vérifier les coordonnées renseignées.
Continuer
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Et voila le document est signé et certifié