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Landline number porting request

By signing this form, you authorise MaxiConnect to transfer your landline number from your current operator. This request constitutes termination of the contract with your previous operator.

1 Account holder's details

Title *

Last name *

First name *

Street and number *

Postal code *

City *

2 Porting type

Individual numbers Up to 10 numbers

DDI block Sequential number range

Main number *

3 Porting date

Respect my current contract's end date

Immediate porting Early termination fees may apply depending on your current operator.

At a desired date

4 Confirmation & Signature

⚠ Important information

This authorisation constitutes termination of the landline phone contract with your previous operator. Early porting may incur termination fees. Other linked services (internet, TV, etc.) require a separate termination.

Place *

Date *

Email address *

Signatory's full name * (in capital letters)

Signature *

Sign here with your mouse or finger

I certify the accuracy of the above information and authorize MaxiConnect to carry out the porting of my number in accordance with the general terms and conditions.

The download generates the PDF without sending it — you can print it, sign it and return it to us.