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Authorization form eRecognition authorization manager assurance level EH4

C.o.C. number

* This field is required

 
Based on the C.o.C. number, the address of your company will be automatically retrieved. This may take several seconds. If the address is not retrieved automatically, please check the C.o.C. number and fill the address in yourself.
C.o.C. number*
 

Company information

 
Trade name organization*
 
Address*
 
Zip code*
 
City*
 
PO/Reference number
 
Would you like to give a specific billing address for this application? (If you do not specify a separate billing address, the invoice will be sent to the authorized representative)  

Authorized representative

* This field is required

 
The authorized representative of the organization has to give permission for the issuance of an authorization manager. In the chamber of commerce (C.o.C.) extract you can see who are authorized to act on behalf of the organization.
An authorized representative gives consent:*  

Company information

 
Are you a legal representative of multiple organizations and do you also want to authorize the authorization manager for these organizations?  

Authorization manager

* This field is required

 
Is this legal representative also the authorization manager of the eRecognition login?  
Fill out the authorization manager details:
Select the authorization manager
 
E-mail address*
 
Thumbprint certificate*
 
Mobile phone number*
 
Do you want to restrict the rights of the authorization manager to a specific branch of your organization?  

Authorizations

 
You should indicate here for which services you want to be authorized, in other words, for which services you want to authorize users for an eRecognition login. First, select the service provider and then the specific service (for example, service provider: RVO.nl and service: mijn.RVO.nl). By selecting "Alle dienstverleners" and "Alle diensten" you are authorized for all current and future services at that level of assurance. We advise you to choose for "Alle diensten" at EH1, no extra fee will be charged for this.
Assurance level EH4
Service provider:
Service:
select
Assurance level EH3
Service provider:
Service:
select
Assurance level EH2+
Service provider:
Service:
select
Assurance level EH2
Service provider:
Service:
select
Assurance level EH1
Service provider:
Service:
select
select

Validity

 
Select the desired duration for your eRecognition login. By the end of this period you will be able to renew your eRecognition login.
select

Invoice summary

 
Expand eHerkenning EH2 with extra admin authorizations € 0,00
All services equal to EH1 € 0,00
Total excluding VAT € 0,00
VAT € 0,00
Total including VAT € 0,00
No refunds will be given for order values less than € 150,- excl. VAT.
In case of an order values less than € 150,- excl. VAT., the order and payment obligations are final.

Regarding your application you will receive an invoice at the following e-mail address: . Please send your payment within 21 days of receiving this invoice.

Checking the provided data

 
Check if all data is filled in correctly. If we receive an incomplete/incorrect form, we cannot process your application.
Authorizations
Validity: 5 years
Assurance level:
Service provider:
Service:
EH1
Alle dienstverleners
Alle diensten EH1
By the end of this period you will be able to renew your eRecognition login.
Invoice summary
Expand eHerkenning EH2 with extra admin authorizations
€ 0,00
 
All services equal to EH1
€ 0,00
 
Total excluding VAT
VAT
Total including VAT
€ ,00
€ ,00
€ ,00
No refunds will be given for order values less than € 150,- excl. VAT.
In case of an order values less than € 150,- excl. VAT., the order and payment obligations are final.

Regarding your application you will receive an invoice at the following e-mail address: . Please send your payment within 21 days of receiving this invoice.

Terms & Conditions

 
To complete your application, you must agree to the following conditions.

Hereby I declare:
Have checked this registration form for accuracy and have filled in truthfully;
To agree to the terms of use Elektronische Toegangsdiensten (Download), the Nederland ICT 2014 terms of use (Download) and the privacy policy of Reconi. In case of inconsistency between the terms of use Elektronische Toegangsdiensten and Nederland ICT 2014 terms of use the latter will prevail.

Completion

 
Thank you for your application. You can download your application here below. As confirmation, you will receive an email on with your application attached to it.
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