ÿþ <html> <head> <title>HandysEntsperren.de - Serviceauftrag - Versandformular - Handysentsperren.de - </title> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <style type="text/css"> .BorderLeft { background-color: #eb7600; border: solid; border-width: 1px 1px 1px 1px; border-color: #000000 black #000000 #000000} .BorderLeft1 { background-color: #eb7600; border: solid; border-width: 1px 0px 1px 1px; border-color: #000000 #D70000 #000000 #000000} .BorderLeftGray { background-color: #FFFFFF; border: 1px #999999 solid; border-width: 0px 1px 1px 1px; border-color: #999999 #999999 #999999 #999999 } .BorderLeftGray1 { background-color: #FFFFFF; border: solid; border-width: 0px 0px 1px 1px; border-color: #FFFFFF #FFFFFF #999999 #999999} .BorderLeftGray2 { background-color: #CCCCCC; border: solid; border-width: 0px 0px 1px 1px; border-color: #FFFFFF #FFFFFF #999999 #999999} .BorderMiddle { background-color: #eb7600; border: solid; border-width: 1px 0px; border-color: #000000 black} .BorderMiddle1 { background-color: #eb7600; border: solid; border-width: 1px 1px; border-color: #000000 black } .BorderMiddleRight { background-color: #eb7600; border: 1px solid; border-width: 1px 1px 1px 1px; border-color: #000000 black #000000 #000000} .BorderMiddleGray { background-color: #FFFFFF; border: solid; border-width: 0px 0px 1px; border-color: #FFFFFF #999999 #999999} .BorderMiddle1Gray { background-color: #FFFFFF; border: solid; border-width: 0px 1px 1px; border-color: #FFFFFF #999999 #999999} .BorderMiddle2Gray { background-color: #CCCCCC; border: solid; border-width: 0px 0px 1px; border-color: #FFFFFF #999999 #999999} .BorderMiddle3Gray { background-color: #CCCCCC; border: solid; border-width: 0px 1px 1px; border-color: #FFFFFF #999999 #999999} .BorderMiddleRightGray { background-color: #FFFFFF; border: solid; border-width: 0px 1px 1px; border-color: #FFFFFF #999999 #999999} .BorderMiddleRightGray1 { background-color: #CCCCCC; border: solid; border-width: 0px 1px 1px 0px; border-color: #FFFFFF #999999 #999999} .BorderOUR { background-color: #FFFFFF; border: solid; border-width: 0px 1px 1px 0px; border-color: #FFFFFF #999999 #999999 #FFFFFF} .BorderOUR1 { background-color: #eb7600; border: solid; border-width: 1px 1px 1px 0px; border-color: #000000 #000000 #000000 #FFFFFF} .BorderOUR2 { background-color: #CCCCCC; border: solid; border-width: 0px 1px 1px 0px; border-color: #FFFFFF #999999 #999999 #FFFFFF} .BorderOUR3 { background-color: #eb7600; border: solid; border-width: 1px 0px 1px 0px; border-color: #000000 #000000 #000000 #FFFFFF} a:link { font-family: Tahoma; font-size: 9pt; font-weight: bold} .BorderMiddleRightGray2 { border: solid; border-width: 0px 1px 1px 0px; border-color: #FFFFFF #999999 #999999 } </style> <script language="JavaScript"> function validate() { var Meldung = "Es müssen alle mit * markierten Felder ausgefüllt werden!" if (window.document.versand.Name.value.length == 0) { alert(Meldung); return; } if (window.document.versand.Strasse.value.length == 0) { alert(Meldung); return; } if (window.document.versand.PLZ.value.length == 0) { alert(Meldung); return; } if (window.document.versand.Ort.value.length == 0) { alert(Meldung); return; } if (window.document.versand.Land.value.length == 0) { alert(Meldung); return; } if (window.document.versand.eMail.value.length == 0) { alert(Meldung); return; } if (window.document.versand.Seriennummer.value.length == 0) { alert("Sie müssen die Seriennummer (IMEI) Ihres Handys angeben!"); return; } if (window.document.versand.agb.checked == false) { alert("Akzeptieren Sie bitte die AGB."); return; } window.print() } </script> </head> <body bgcolor="#FFFFFF"> <div align="center"> <form name="versand"> <table width="90%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="30%" class="BorderLeft" style="background-color: #FFFFFF"> <p align="center"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF">&nbsp;&nbsp;</font></td> <td width="40%" align="center" class="BorderMiddle" style="background-color: #FFFFFF"> <font face="Lucida Bright" size="4"><b> <span style="background-color: #FFFFFF">Versandformular - Serviceauftrag</span></b></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font> </td> <td width="30%" align="right" class="BorderMiddleRight" style="background-color: #FFFFFF"> <p align="center"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF">http://www.handysentsperren.de&nbsp; </font> </td> </tr> </table> <table width="90%" border="0" cellspacing="0" cellpadding="0"> <tr valign="top"> <td width="45%" bgcolor="#eeeeee" class="BorderLeftGray"> <div align="center"><span class="top"><b> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF">Kundendaten</font></b></span><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"><br> </font> <font face="Lucida Bright" size="1"> <span style="background-color: #FFFFFF">die mit * markierten Felder müssen ausgefüllt werden!<br> </span> </font> </div> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="30%" valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Name:*</font></td> <td valign="top"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Name" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Vorname:</font></td> <td valign="top"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Vorname" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Straße Nr.:*</font></td> <td valign="top"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Strasse" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;PLZ / Ort*</font></td> <td valign="top"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="PLZ" size="5" maxlength="5" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font><font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ort" size="22" maxlength="22" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF"> &nbsp;Land:*</font></td> <td valign="top"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Land" value="Österreich" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr> <td colspan="2" align="center" height="50"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF"><br> Wichtig für mögliche Rückfragen:<br> </font></td> </tr> <tr> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Telefon:</font></td> <td valign="top"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Telefon1" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Mobil: </font></td> <td valign="top"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Telefon2" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr> <td align="left" valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF"> &nbsp;eMail-Adresse:*</font></td> <td><font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="eMail" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> </table> </td> <td width="5%"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF">&nbsp;</font></td> <td width="45%" bgcolor="#eeeeee" class="BorderLeftGray"> <div align="center"> <span class="top"><b> <font face="Lucida Bright" style="font-size: 9pt"> <span style="background-color: #FFFFFF">Rücksendeadresse</span></font></b><font face="Lucida Bright" style="font-size: 9pt"><span style="background-color: #FFFFFF"><br> </span> </font> </span><font size="1" face="Lucida Bright"> <span style="background-color: #FFFFFF">Falls die Adresse für den Rückweg abweicht!! </span> </font></div> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr valign="top"> <td valign="middle" width="30%"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Name:</font></td> <td width="69%"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_Name" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr valign="top"> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Vorname:</font></td> <td> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_Vorname" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr valign="top"> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Straße Nr:</font></td> <td> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_Strasse" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr valign="top"> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF"> &nbsp;PLZ / Ort:</font></td> <td> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_PLZ" size="5" maxlength="5" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font><font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_Ort" size="22" maxlength="22" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr valign="top"> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF"> &nbsp;Land:</font></td> <td> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_Land" value="Österreich" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr valign="top"> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF">&nbsp;Telefon:</font></td> <td> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_Telefon1" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr valign="top"> <td valign="middle"> <font face="Lucida Bright" style="font-size: 8pt; background-color:#FFFFFF"> &nbsp;Mobil: </font></td> <td> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Ruecksende_Telefon2" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font><font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> </font></td> </tr> <tr valign="top"> <td valign="baseline"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF">&nbsp;</font></td> <td> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> <br> <br> </font></td> </tr> </table> </td> </tr> </table><span style="background-color: #FFFFFF"><br> </span> <table border="0" width="90%" id="table1" style="border-collapse: collapse"> <tr> <td> <table border="0" width="100%" id="table2" style="border-collapse: collapse"> <tr> <td class="BorderLeft" style="background-color: #FFFFFF"> <p align="center"> <font face="Lucida Bright" style="font-size: 9pt; font-weight: 700; background-color:#FFFFFF"> Dienstleistung</font></td> </tr> </table> <table border="1" width="100%" id="table3" style="border-collapse: collapse" height="40"> <tr> <td width="14%" height="16"> <span style="font-size: 9pt; background-color:#FFFFFF">Entsperren</span></td> <td width="86%" height="16"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Entsperren" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font></td> </tr> <tr> <td width="14%" height="19"> <span style="font-size: 9pt; background-color:#FFFFFF">Entbranden</span></td> <td width="86%" height="19"> <font size="1" face="Lucida Bright"> <span style="font-size: 9pt"> <input type="text" name="Entbranden" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt"></span></font></td> </tr> </table> </td> </tr> </table><span style="background-color: #FFFFFF">&nbsp;<br> </span> <table width="90%" border="0" cellspacing="0" cellpadding="0" bgcolor="#eeeeee"> <tr align="center"> <td height="28" colspan="2" class="BorderLeft" style="background-color: #FFFFFF"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> <b><tr class="BorderLeft"> <td valign="top" align="center" width="50%" class="BorderLeftGray"> <font face="Lucida Bright" size="1"> <span style="background-color: #FFFFFF">Geräte-Typ: </span> </font> <font face="Lucida Bright" size="2"> <span style="font-size: 8pt"><font size="1"> <input type="text" name="HandyTyp" size="30" maxlength="30" style="font-family: Tahoma; font-size:8pt" value="Bitte eintragen"></font></span></font><font face="Lucida Bright" size="1"><span style="background-color: #FFFFFF"> </span> </font></td> <td width="50%" align="center" class="BorderOUR"> <font face="Lucida Bright" size="1"> <span style="background-color: #FFFFFF">Seriennummer (IMEI):&nbsp; </span> </font> <font face="Lucida Bright" size="2"> <span style="font-size: 8pt"><font size="1"> <span style="background-color: #FFFFFF">&nbsp;</span><!--webbot bot="Validation" s-data-type="Integer" s-number-separators="x" i-maximum-length="18" --><input type="text" name="Seriennummer" size="20" maxlength="18" style="font-family: Tahoma; font-size:8pt" value="Bitte eintragen"></font></span></font><font face="Lucida Bright" size="1"><span style="background-color: #FFFFFF"> <br> </span> </font> <font face="Lucida Bright" style="font-size: 7pt; background-color:#FFFFFF"> Die 15-stellige Seriennummer (IMEI) steht auf dem Aufkleber unter dem Akku des Gerätes. </font> </td> </tr> </table> <font face="Lucida Bright" size="1"> <span style="background-color: #FFFFFF"> <br> </span> </font> <table width="695" border="0" cellspacing="0" cellpadding="0" bgcolor="#eeeeee"> <tr valign="top"> <td colspan="3" class="BorderLeft" width="1103"> <p align="left"> <font size="1" face="Tahoma"> <span style="font-size: 9pt"> <textarea rows='3' cols='135' wrap='virtual' style="font-family: Tahoma; font-size:8pt" name="mitteilung">Ihre Mitteilung an uns...</textarea></span></font></td> </tr> </table> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> <br> </font> <table width="90%" border="0" cellspacing="0" cellpadding="0" bgcolor="#eeeeee" height="75"> <tr valign="middle"> <td class="BorderLeft" height="28" style="background-color: #FFFFFF" > <div align="center"><b> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> Zahlungsmöglichkeit Barzahlung oder Moneybookers.com</font></b></div> </td> </tr> <tr valign="middle" class="BorderOUR"> <td> <table class="BorderLeftGray" width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="3%" height="2"> </td> <td width="9%" height="2"></td> <td width="88%" height="2"></td> </tr> <tr> <td width="3%" valign="top" bgcolor="#E8E8E8"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF">&nbsp;</font></td> <td width="87%" valign="top" bgcolor="#E8E8E8"> <font face="Lucida Bright" style="font-size: 12pt; background-color:#FFFFFF"> Der Entsperr-Betrag liegt im Paket bei, zzgl. ca. ¬ 6,00 <b>(AT)</b> oder ca. ¬ 8,50 <b>(EU) </b> Rückportokosten versichert (schnellste Bearbeitung)</font></td> </tr> </table> </td> </tr> </table> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> <br> </font> <table width="90%" border="0" cellspacing="0" cellpadding="0" bgcolor="#eeeeee"> <tr> <td class="BorderLeft" height="28" valign="middle" align="center" style="background-color: #FFFFFF"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"><b>Zusatz</b></font></td> </tr> <tr> <td class="BorderLeftGray" valign="middle" align="center"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF">Sondervereinbarung / weitere Bemerkungen</font><font face="Lucida Bright"><font style="font-size: 9pt; background-color:#FFFFFF"><br> </font><font size="1" face="Tahoma"><span style="font-size: 9pt"> <input type="text" name="textfield18" size="70" maxlength="70" style="font-family: Tahoma; font-size:8pt"></span></font><font style="font-size: 9pt; background-color:#FFFFFF"> <br> </font><span style="font-size: 9pt"><font size="1"> <input type="text" name="textfield21" size="70" maxlength="70" style="font-family: Tahoma; font-size:8pt"></font></span><font style="font-size: 9pt; background-color:#FFFFFF"> </font> </td> </tr> </table> <table width="90%" border="0" cellspacing="0" cellpadding="0"> <tr> <td> <table border="0" width="100%" id="table4" style="border-collapse: collapse"> <tr> <td valign="top" width="100%" align="center" colspan="2"> <p><b><font face="Lucida Bright"> <span style="background-color: #FFFFFF"></span></font></b><font face="Lucida Bright" size="2"><b><span style="background-color: #FFFFFF"></span></font></td> </tr> <tr> <td valign="top" width="50%" align="center"> &nbsp;</td> <td valign="bottom" width="50%" align="center"> &nbsp;</td> </tr> </table> </td> </tr> <tr> <td> <b> <font face="Lucida Bright" style="font-size: 12pt; background-color:#FFFFFF"> <input type="checkbox" name="agb" onClick="Javascript:validate();"<font face="Lucida Bright" value="ON">Ja, ich akzeptiere mit meiner Unterschrift die </font><a href="http://www.handyentsperren.at/faq.html#agb">Allgemeine Geschäfts- &amp; Nutzungsbedingungen</a>&nbsp; (AGB) gelesen zu haben und Außerdem verzichte ich bei dieser Dienstleistung auf mein Widerrufsrecht:</b><br> </font> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td valign="top" width="50%"> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> <br> &nbsp;<b>Unterschrift</b>:&nbsp;&nbsp;____________________________ </font> </td> <td valign="bottom" width="50%"> <div align="right"><a href="javascript:validate()">Versandformular ausdrucken!</a> <font face="Lucida Bright" size="1"><b> </div> </td> </tr> </table> </td> </tr> </table> <font face="Lucida Bright" style="font-size: 9pt; background-color:#FFFFFF"> <br> </font> </form> </div> </body> </html>