Otomatik Ödeme Talimatı Formu
Faturalarınızın otomatik olarak ödenmesi için gerekli bilgileri eksiksiz doldurunuz.
Adınız ve Soyadınız
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Ad
Soyad
Telefon Numaranız
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Lütfen geçerli bir telefon numarası girin.
Format: (000) 000-0000.
E-posta Adresiniz
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ornek@ornek.com
Adresiniz
Adres Satırı 1
Adres Satırı 2
İlçe
İl / Eyalet
Posta Kodu
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
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Aruba
Australia
Austria
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Fiji
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Mali
Malta
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Martinique
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Mayotte
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Nagorno-Karabakh
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Nepal
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Netherlands Antilles
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Nigeria
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Peru
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Poland
Portugal
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Romania
Russia
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Saint Barthelemy
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Samoa
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Senegal
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eSwatini
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US Virgin Islands
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Other
Ülke
Otomatik ödeme talimatı vermek istediğiniz kurum/firma adı
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Fatura türü
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Please Select
Elektrik
Su
Doğalgaz
Telefon/İnternet
Diğer
Abone numarası veya müşteri numarası (varsa)
Otomatik ödeme başlama tarihi
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-
Ay
-
Gün
Yıl
2 digit month, 2 digit day, 4 digit year
Tarih
Açıklama veya eklemek istediğiniz bir notunuz varsa yazınız
Talimatı Gönder
Should be Empty: