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Name

Spouse/cohabitant's name

Customer number

Installation number

Street name and house number

Postal code

City

Phone number

Mobile phone number *

E-mail address *

E-mailadresse igen: *

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Attachments must be of type .xlsx, .xls, .doc, .docx, .pdf, .bmp, .jpeg, .jpg or .png.
Max. file size: 50 mb per file.

I hereby give AffaldVarme Aarhus A/S my consent to use the information entered. I am aware of my right to recall my consent. *

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