{"id":16492,"date":"2026-02-09T09:37:07","date_gmt":"2026-02-09T09:37:07","guid":{"rendered":"https:\/\/www.tmb.cd\/?page_id=16492"},"modified":"2026-04-09T08:18:18","modified_gmt":"2026-04-09T08:18:18","slug":"claim-form","status":"publish","type":"page","link":"https:\/\/www.tmb.cd\/en\/claim-form\/","title":{"rendered":"Claim Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"16492\" class=\"elementor elementor-16492 elementor-14654\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5a8c4f1 e-flex e-con-boxed e-con e-parent\" data-id=\"5a8c4f1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-85f13ad elementor-widget elementor-widget-heading\" data-id=\"85f13ad\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Claim Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d93b37f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"d93b37f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d9d8e91 eael-contact-form-7-button-align-left eael-contact-form-7-button-custom elementor-widget elementor-widget-eael-contact-form-7\" data-id=\"d9d8e91\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"eael-contact-form-7.default\">\n\t\t\t\t\t<div class=\"eael-contact-form-7-wrapper\">\n                <div class=\"eael-contact-form eael-contact-form-7 eael-contact-form-d9d8e91 placeholder-show eael-contact-form-align-default\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f10738-o1\" lang=\"fr-FR\" dir=\"ltr\" data-wpcf7-id=\"10738\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/16492#wpcf7-f10738-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulaire de contact\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"10738\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.7\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fr_FR\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f10738-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:10738,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;group-664&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-828&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;AUTRE (Veuillez pr\\u00e9ciser)&quot;}]},{&quot;then_field&quot;:&quot;group-665&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;menu-397&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;AUTRE (Veuillez pr\\u00e9ciser)&quot;}]},{&quot;then_field&quot;:&quot;group-666&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-828&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Carte bancaire&quot;}]},{&quot;then_field&quot;:&quot;group-667&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-828&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Carte bancaire&quot;}]},{&quot;then_field&quot;:&quot;group-668&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-828&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Carte bancaire&quot;}]},{&quot;then_field&quot;:&quot;group-669&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-828&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Carte bancaire&quot;}]},{&quot;then_field&quot;:&quot;group-670&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-828&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Carte bancaire&quot;}]},{&quot;then_field&quot;:&quot;group-885&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;menu-399&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;AUTRE (Veuillez pr\\u00e9ciser)&quot;}]},{&quot;then_field&quot;:&quot;group-888&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-441&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Agent de la banque&quot;}]},{&quot;then_field&quot;:&quot;group-222&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radio-999&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Oui&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/>\n<\/fieldset>\n<div class=\"cf7-form\">\n\t<div class=\"cf7-grid\">\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Nom <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Postnoms <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"postnoms\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"postnoms\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Pr\u00e9noms <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-prenom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-prenom\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">T\u00e9l\u00e9phone <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-128\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-128\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<p><label class=\"cf7-field cf7-span-2\"><br \/>\n<span class=\"cf7-label\">E-mail <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t<\/div>\n\t<h3 class=\"cf7-section\">Avez-vous un compte TMB ?\n\t<\/h3>\n\t<div class=\"cf7-block\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-999\"><span class=\"wpcf7-form-control wpcf7-radio cf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-999\" value=\"Oui\" \/><span class=\"wpcf7-list-item-label\">Oui<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-999\" value=\"Non\" \/><span class=\"wpcf7-list-item-label\">Non<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div data-id=\"group-222\" data-orig_data_id=\"group-222\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<div class=\"cf7-block\">\n\t\t\t<div class=\"cf7-label\">\n\t\t\t\t<p>Num\u00e9ro de compte\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"cf7-cardrow\">\n\t\t\t\t<p><span class=\"cf7-prefix\">00017<\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<p><input type=\"text\" name=\"compte-numero-1\" id=\"compte-numero-1\" class=\"cf7-box cf7-box-left\" maxlength=\"5\" inputmode=\"numeric\" pattern=\"[0-9]*\" autocomplete=\"off\" \/><br \/>\n<input type=\"password\" name=\"compte-numero-2\" id=\"compte-numero-2\" class=\"cf7-box cf7-box-mid\" maxlength=\"11\" inputmode=\"numeric\" pattern=\"[0-9]*\" autocomplete=\"off\" \/><br \/>\n<input type=\"text\" name=\"compte-numero-3\" id=\"compte-numero-3\" class=\"cf7-box cf7-box-right\" maxlength=\"2\" inputmode=\"numeric\" pattern=\"[0-9]*\" autocomplete=\"off\" \/>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<input class=\"wpcf7-form-control wpcf7-hidden\" id=\"compte-numero\" value=\"\" type=\"hidden\" name=\"your-num\" \/>\n\t\t<\/div>\n\t<\/div>\n\t<h3 class=\"cf7-section\">Cette r\u00e9clamation concerne (un seul choix possible):\n\t<\/h3>\n\t<div class=\"cf7-block cf7-columns-2\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-828\"><span class=\"wpcf7-form-control wpcf7-radio cf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-828\" value=\"Carte bancaire\" \/><span class=\"wpcf7-list-item-label\">Carte bancaire<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Ch\u00e8ques et OP\" \/><span class=\"wpcf7-list-item-label\">Ch\u00e8ques et OP<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Coffre-fort\" \/><span class=\"wpcf7-list-item-label\">Coffre-fort<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Communication\/publicit\u00e9\" \/><span class=\"wpcf7-list-item-label\">Communication\/publicit\u00e9<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Cr\u00e9dit entreprise\" \/><span class=\"wpcf7-list-item-label\">Cr\u00e9dit entreprise<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Cr\u00e9dit particulier\" \/><span class=\"wpcf7-list-item-label\">Cr\u00e9dit particulier<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Cr\u00e9dit salari\u00e9\" \/><span class=\"wpcf7-list-item-label\">Cr\u00e9dit salari\u00e9<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Cr\u00e9doc et remise documentaire\" \/><span class=\"wpcf7-list-item-label\">Cr\u00e9doc et remise documentaire<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"D\u00e9p\u00f4t\/retrait\" \/><span class=\"wpcf7-list-item-label\">D\u00e9p\u00f4t\/retrait<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Distributeur de billets (DAB-ATM)\" \/><span class=\"wpcf7-list-item-label\">Distributeur de billets (DAB-ATM)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"FOREX\" \/><span class=\"wpcf7-list-item-label\">FOREX<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Gestion des comptes\" \/><span class=\"wpcf7-list-item-label\">Gestion des comptes<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Institution financi\u00e8re\" \/><span class=\"wpcf7-list-item-label\">Institution financi\u00e8re<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Institution internationale\" \/><span class=\"wpcf7-list-item-label\">Institution internationale<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Licence bancaire\" \/><span class=\"wpcf7-list-item-label\">Licence bancaire<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"NetBank\" \/><span class=\"wpcf7-list-item-label\">NetBank<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Paie des fonctionnaires\" \/><span class=\"wpcf7-list-item-label\">Paie des fonctionnaires<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Paiement fournisseurs\" \/><span class=\"wpcf7-list-item-label\">Paiement fournisseurs<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"PEPELE Mobile Agent ind\u00e9pendant\" \/><span class=\"wpcf7-list-item-label\">PEPELE Mobile Agent ind\u00e9pendant<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"PEPELE Mobile Client\" \/><span class=\"wpcf7-list-item-label\">PEPELE Mobile Client<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"PEPELE Mobile Compte entreprise\" \/><span class=\"wpcf7-list-item-label\">PEPELE Mobile Compte entreprise<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"PEPELE Mobile Facturier\/Marchand\" \/><span class=\"wpcf7-list-item-label\">PEPELE Mobile Facturier\/Marchand<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Pepele Transfert d\u2019argent\" \/><span class=\"wpcf7-list-item-label\">Pepele Transfert d\u2019argent<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"R\u00e9gie financi\u00e8re\" \/><span class=\"wpcf7-list-item-label\">R\u00e9gie financi\u00e8re<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Sponsoring\" \/><span class=\"wpcf7-list-item-label\">Sponsoring<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Terminal de paiement \u00e9lectronique (TPE-POS)\" \/><span class=\"wpcf7-list-item-label\">Terminal de paiement \u00e9lectronique (TPE-POS)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Transfert international\" \/><span class=\"wpcf7-list-item-label\">Transfert international<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Transfert interne\" \/><span class=\"wpcf7-list-item-label\">Transfert interne<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-828\" value=\"Transfert national\" \/><span class=\"wpcf7-list-item-label\">Transfert national<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-828\" value=\"AUTRE (Veuillez pr\u00e9ciser)\" \/><span class=\"wpcf7-list-item-label\">AUTRE (Veuillez pr\u00e9ciser)<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div data-id=\"group-664\" data-orig_data_id=\"group-664\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Veuillez pr\u00e9ciser <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"autre-lieux\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"autre-lieux\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div data-id=\"group-666\" data-orig_data_id=\"group-666\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<div class=\"cf7-block\">\n\t\t\t<div class=\"cf7-label\">\n\t\t\t\t<p>Num\u00e9ro de la carte (veuillez introduire les 16 chiffres)\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"cf7-cardrow\">\n\t\t\t\t<p><input type=\"text\" name=\"carte-numero-1\" id=\"carte-numero-1\" class=\"cf7-box cf7-box-left\" maxlength=\"4\" inputmode=\"numeric\" pattern=\"[0-9]*\" autocomplete=\"off\" \/><br \/>\n<input type=\"password\" name=\"carte-numero-2\" id=\"carte-numero-2\" class=\"cf7-box cf7-box-mid\" maxlength=\"8\" inputmode=\"numeric\" pattern=\"[0-9]*\" autocomplete=\"off\" \/><br \/>\n<input type=\"text\" name=\"carte-numero-3\" id=\"carte-numero-3\" class=\"cf7-box cf7-box-right\" maxlength=\"4\" inputmode=\"numeric\" pattern=\"[0-9]*\" autocomplete=\"off\" \/>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<input class=\"wpcf7-form-control wpcf7-hidden\" id=\"carte-numero\" value=\"\" type=\"hidden\" name=\"carte-numero\" \/>\n\t\t<\/div>\n\t<\/div>\n\t<div data-id=\"group-667\" data-orig_data_id=\"group-667\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<div class=\"cf7-block\">\n\t\t\t<div class=\"cf7-label\">\n\t\t\t\t<p>Veuillez pr\u00e9ciser s'il s'agit d'un paiement en ligne, sur POS ou sur DAB\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-494\"><span class=\"wpcf7-form-control wpcf7-radio cf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-494\" value=\"Paiement en ligne\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Paiement en ligne<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-494\" value=\"TPE-POS\" \/><span class=\"wpcf7-list-item-label\">TPE-POS<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-494\" value=\"DAB-ATM\" \/><span class=\"wpcf7-list-item-label\">DAB-ATM<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div data-id=\"group-668\" data-orig_data_id=\"group-668\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Montant de l'op\u00e9ration contest\u00e9e <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"carte-montant\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"carte-montant\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div data-id=\"group-670\" data-orig_data_id=\"group-670\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Devise<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"select-currency\"><select class=\"wpcf7-form-control wpcf7-select cf7-input\" aria-invalid=\"false\" name=\"select-currency\"><option value=\"CDF\">CDF<\/option><option value=\"$ USD\">$ USD<\/option><option value=\"\u20ac EUR\">\u20ac EUR<\/option><\/select><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div data-id=\"group-669\" data-orig_data_id=\"group-669\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Objet de r\u00e9clamation <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"carte-reclamation\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required cf7-textarea\" aria-required=\"true\" aria-invalid=\"false\" name=\"carte-reclamation\"><\/textarea><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t<\/div>\n\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Lieu de l\u2019incident <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-397\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" name=\"menu-397\"><option value=\"- - LUBUMBASHI - -\">- - LUBUMBASHI - -<\/option><option value=\"Lumumba - Si\u00e8ge social\">Lumumba - Si\u00e8ge social<\/option><option value=\"Moero\">Moero<\/option><option value=\"Lomami\">Lomami<\/option><option value=\"PNC-Ville\">PNC-Ville<\/option><option value=\"Planet Hollybum - TMB Plus\">Planet Hollybum - TMB Plus<\/option><option value=\"Stade TP Mazembe\">Stade TP Mazembe<\/option><option value=\"Ruashi\">Ruashi<\/option><option value=\"Hyper Psaro Carrefour\">Hyper Psaro Carrefour<\/option><option value=\"SNCC\">SNCC<\/option><option value=\"La Plage\">La Plage<\/option><option value=\"Grand Karavia - TMB Plus\">Grand Karavia - TMB Plus<\/option><option value=\"Galerie Azzas\">Galerie Azzas<\/option><option value=\"La Luano\">La Luano<\/option><option value=\"\"><\/option><option value=\"- - KINSHASA - -\">- - KINSHASA - -<\/option><option value=\"Place du March\u00e9 - Si\u00e8ge\">Place du March\u00e9 - Si\u00e8ge<\/option><option value=\"Boulevard\">Boulevard<\/option><option value=\"H\u00f4tel du Gouvernement\">H\u00f4tel du Gouvernement<\/option><option value=\"Galerie du Fleuve\">Galerie du Fleuve<\/option><option value=\"Memling - TMB Plus\">Memling - TMB Plus<\/option><option value=\"Memling II\">Memling II<\/option><option value=\"Hyper Psaro\">Hyper Psaro<\/option><option value=\"Grand H\u00f4tel\">Grand H\u00f4tel<\/option><option value=\"Fleuve Congo H\u00f4tel - TMB Plus\">Fleuve Congo H\u00f4tel - TMB Plus<\/option><option value=\"Bon March\u00e9\">Bon March\u00e9<\/option><option value=\"Shoprite\">Shoprite<\/option><option value=\"Ma Campagne\">Ma Campagne<\/option><option value=\"UPN\">UPN<\/option><option value=\"Monishop Center\">Monishop Center<\/option><option value=\"Bandal\">Bandal<\/option><option value=\"Victoire\">Victoire<\/option><option value=\"Limete\">Limete<\/option><option value=\"Hasson &amp; Fr\u00e8res Limete\">Hasson &amp; Fr\u00e8res Limete<\/option><option value=\"Ndjili\">Ndjili<\/option><option value=\"Unikin\">Unikin<\/option><option value=\"\"><\/option><option value=\"- - EQUATEUR - -\">- - EQUATEUR - -<\/option><option value=\"Mbandaka\">Mbandaka<\/option><option value=\"\"><\/option><option value=\"- - HAUT-KATANGA - -\">- - HAUT-KATANGA - -<\/option><option value=\"Kasumbalesa\">Kasumbalesa<\/option><option value=\"Kasumbalesa - Wiski\">Kasumbalesa - Wiski<\/option><option value=\"Kilwa\">Kilwa<\/option><option value=\"Likasi\">Likasi<\/option><option value=\"\"><\/option><option value=\"- - HAUT-LOMAMI - -\">- - HAUT-LOMAMI - -<\/option><option value=\"Kamina\">Kamina<\/option><option value=\"\"><\/option><option value=\"- - ITURI - -\">- - ITURI - -<\/option><option value=\"Bunia\">Bunia<\/option><option value=\"\"><\/option><option value=\"- - KASA\u00cf-CENTRAL - -\">- - KASA\u00cf-CENTRAL - -<\/option><option value=\"Kananga\">Kananga<\/option><option value=\"\"><\/option><option value=\"- - KASA\u00cf-ORIENTAL - -\">- - KASA\u00cf-ORIENTAL - -<\/option><option value=\"Mbuji-Mayi\">Mbuji-Mayi<\/option><option value=\"\"><\/option><option value=\"- - KONGO-CENTRAL - -\">- - KONGO-CENTRAL - -<\/option><option value=\"Boma\">Boma<\/option><option value=\"Matadi\">Matadi<\/option><option value=\"Matadi - Port Sec Aidel-Ticom\">Matadi - Port Sec Aidel-Ticom<\/option><option value=\"Muanda\">Muanda<\/option><option value=\"\"><\/option><option value=\"- - KWANGO - -\">- - KWANGO - -<\/option><option value=\"Kenge\">Kenge<\/option><option value=\"\"><\/option><option value=\"- - KWILU - -\">- - KWILU - -<\/option><option value=\"Bandundu\">Bandundu<\/option><option value=\"Kikwit\">Kikwit<\/option><option value=\"\"><\/option><option value=\"- - LOMAMI - -\">- - LOMAMI - -<\/option><option value=\"Kabinda\">Kabinda<\/option><option value=\"Mwene-Ditu\">Mwene-Ditu<\/option><option value=\"\"><\/option><option value=\"- - LUALABA - -\">- - LUALABA - -<\/option><option value=\"Fungurume\">Fungurume<\/option><option value=\"Kolwezi\">Kolwezi<\/option><option value=\"Kolwezi - TMB Plus\">Kolwezi - TMB Plus<\/option><option value=\"Kolwezi - DRLU\">Kolwezi - DRLU<\/option><option value=\"\"><\/option><option value=\"- - MANIEMA - -\">- - MANIEMA - -<\/option><option value=\"Kindu\">Kindu<\/option><option value=\"\"><\/option><option value=\"- - NORD-KIVU - -\">- - NORD-KIVU - -<\/option><option value=\"Beni\">Beni<\/option><option value=\"Butembo\">Butembo<\/option><option value=\"Goma\">Goma<\/option><option value=\"Goma - TMB Plus\">Goma - TMB Plus<\/option><option value=\"Goma - Ihusi\">Goma - Ihusi<\/option><option value=\"Goma - Jambo Safari\">Goma - Jambo Safari<\/option><option value=\"Goma - Mairie\">Goma - Mairie<\/option><option value=\"Goma - Ihusi H\u00f4tel\">Goma - Ihusi H\u00f4tel<\/option><option value=\"Goma - Grande Barri\u00e8re 1\">Goma - Grande Barri\u00e8re 1<\/option><option value=\"Logu\">Logu<\/option><option value=\"\"><\/option><option value=\"- - NORD-UBANGI - -\">- - NORD-UBANGI - -<\/option><option value=\"Gbadolite\">Gbadolite<\/option><option value=\"\"><\/option><option value=\"- - SANKURU - -\">- - SANKURU - -<\/option><option value=\"Lodja\">Lodja<\/option><option value=\"\"><\/option><option value=\"- - SUD-KIVU - -\">- - SUD-KIVU - -<\/option><option value=\"Bukavu\">Bukavu<\/option><option value=\"Bukavu - Panorama H\u00f4tel - TMB Plus\">Bukavu - Panorama H\u00f4tel - TMB Plus<\/option><option value=\"Bukavu - ISP\">Bukavu - ISP<\/option><option value=\"Bukavu - Panzi\">Bukavu - Panzi<\/option><option value=\"Bukavu - DGDA\">Bukavu - DGDA<\/option><option value=\"Uvira\">Uvira<\/option><option value=\"\"><\/option><option value=\"- - SUD-UBANGI - -\">- - SUD-UBANGI - -<\/option><option value=\"Gemena\">Gemena<\/option><option value=\"\"><\/option><option value=\"- - TANGANYIKA - -\">- - TANGANYIKA - -<\/option><option value=\"Kalemie\">Kalemie<\/option><option value=\"Manono\">Manono<\/option><option value=\"\"><\/option><option value=\"- - TSHOPO - -\">- - TSHOPO - -<\/option><option value=\"Kisangani\">Kisangani<\/option><option value=\"\"><\/option><option value=\"- - GUICHETS PEPELE MOBILE - -\">- - GUICHETS PEPELE MOBILE - -<\/option><option value=\"Lubumbashi cadastre\">Lubumbashi cadastre<\/option><option value=\"Kinshasa Egal Barumbu\">Kinshasa Egal Barumbu<\/option><option value=\"Kinshasa Egal UPN\">Kinshasa Egal UPN<\/option><option value=\"Goma cadastre\">Goma cadastre<\/option><option value=\"\"><\/option><option value=\"- - GUICHETS POLICE ET ARM\u00c9E - -\">- - GUICHETS POLICE ET ARM\u00c9E - -<\/option><option value=\"- LUBUMBASHI -\">- LUBUMBASHI -<\/option><option value=\"Camp Bel Air\">Camp Bel Air<\/option><option value=\"PNC - Ville\">PNC - Ville<\/option><option value=\"- KINSHASA -\">- KINSHASA -<\/option><option value=\"EMG1\">EMG1<\/option><option value=\"EMG2\">EMG2<\/option><option value=\"Tshatshi\">Tshatshi<\/option><option value=\"Camp Kokolo\">Camp Kokolo<\/option><option value=\"Circo\">Circo<\/option><option value=\"Camp Lufungula\">Camp Lufungula<\/option><option value=\"LNI\">LNI<\/option><option value=\"Camp Kabila\">Camp Kabila<\/option><option value=\"Ceta\">Ceta<\/option><option value=\"Kibomango\">Kibomango<\/option><option value=\"Maluku\">Maluku<\/option><option value=\"- HAUT-LOMAMI -\">- HAUT-LOMAMI -<\/option><option value=\"Camp militaire Kamina\">Camp militaire Kamina<\/option><option value=\"- KONGO-CENTRAL -\">- KONGO-CENTRAL -<\/option><option value=\"Muanda - Base de Kitona\">Muanda - Base de Kitona<\/option><option value=\"Mbanza-Ngungu\">Mbanza-Ngungu<\/option><option value=\"- SUD-KIVU -\">- SUD-KIVU -<\/option><option value=\"Bukavu - PNC Bukavu\">Bukavu - PNC Bukavu<\/option><option value=\"\"><\/option><option value=\"- - GUICHETS CORPORATE - -\">- - GUICHETS CORPORATE - -<\/option><option value=\"Kamoa\">Kamoa<\/option><option value=\"Logu\">Logu<\/option><option value=\"\"><\/option><option value=\"AUTRE (Veuillez pr\u00e9ciser)\">AUTRE (Veuillez pr\u00e9ciser)<\/option><\/select><\/span><br \/>\n<\/label>\n\t<\/p>\n\t<div data-id=\"group-665\" data-orig_data_id=\"group-665\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Veuillez pr\u00e9ciser <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"autre\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"autre\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t<\/div>\n\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Date de l\u2019incident<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-315\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date cf7-input\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-315\" \/><\/span><br \/>\n<\/label>\n\t<\/p>\n\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Veuillez d\u00e9crire l'objet de votre r\u00e9clamation <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required cf7-textarea\" aria-required=\"true\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span><br \/>\n<\/label>\n\t<\/p>\n\t<h3 class=\"cf7-section\">Information concernant la personne qui compl\u00e8te ce formulaire de r\u00e9clamation\n\t<\/h3>\n\t<div class=\"cf7-block\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-441\"><span class=\"wpcf7-form-control wpcf7-radio cf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-441\" value=\"Client de la banque\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Client de la banque<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-441\" value=\"Agent de la banque\" \/><span class=\"wpcf7-list-item-label\">Agent de la banque<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-441\" value=\"Ni client ni agent de la Banque\" \/><span class=\"wpcf7-list-item-label\">Ni client ni agent de la Banque<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div data-id=\"group-888\" data-orig_data_id=\"group-888\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Nom de l'agent <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-agent\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-agent\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">E-mail de l'agent <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email-agent\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email-agent\" \/><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Agence de l\u2019agent <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-399\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" name=\"menu-399\"><option value=\"- - LUBUMBASHI - -\">- - LUBUMBASHI - -<\/option><option value=\"Lumumba - Si\u00e8ge social\">Lumumba - Si\u00e8ge social<\/option><option value=\"Moero\">Moero<\/option><option value=\"Lomami\">Lomami<\/option><option value=\"PNC-Ville\">PNC-Ville<\/option><option value=\"Planet Hollybum - TMB Plus\">Planet Hollybum - TMB Plus<\/option><option value=\"Stade TP Mazembe\">Stade TP Mazembe<\/option><option value=\"Ruashi\">Ruashi<\/option><option value=\"Hyper Psaro Carrefour\">Hyper Psaro Carrefour<\/option><option value=\"SNCC\">SNCC<\/option><option value=\"La Plage\">La Plage<\/option><option value=\"Grand Karavia - TMB Plus\">Grand Karavia - TMB Plus<\/option><option value=\"Galerie Azzas\">Galerie Azzas<\/option><option value=\"La Luano\">La Luano<\/option><option value=\"\"><\/option><option value=\"- - KINSHASA - -\">- - KINSHASA - -<\/option><option value=\"Place du March\u00e9 - Si\u00e8ge\">Place du March\u00e9 - Si\u00e8ge<\/option><option value=\"Boulevard\">Boulevard<\/option><option value=\"H\u00f4tel du Gouvernement\">H\u00f4tel du Gouvernement<\/option><option value=\"Galerie du Fleuve\">Galerie du Fleuve<\/option><option value=\"Memling - TMB Plus\">Memling - TMB Plus<\/option><option value=\"Memling II\">Memling II<\/option><option value=\"Hyper Psaro\">Hyper Psaro<\/option><option value=\"Grand H\u00f4tel\">Grand H\u00f4tel<\/option><option value=\"Fleuve Congo H\u00f4tel - TMB Plus\">Fleuve Congo H\u00f4tel - TMB Plus<\/option><option value=\"Bon March\u00e9\">Bon March\u00e9<\/option><option value=\"Shoprite\">Shoprite<\/option><option value=\"Ma Campagne\">Ma Campagne<\/option><option value=\"UPN\">UPN<\/option><option value=\"Monishop Center\">Monishop Center<\/option><option value=\"Bandal\">Bandal<\/option><option value=\"Victoire\">Victoire<\/option><option value=\"Limete\">Limete<\/option><option value=\"Hasson &amp; Fr\u00e8res Limete\">Hasson &amp; Fr\u00e8res Limete<\/option><option value=\"Ndjili\">Ndjili<\/option><option value=\"Unikin\">Unikin<\/option><option value=\"\"><\/option><option value=\"- - EQUATEUR - -\">- - EQUATEUR - -<\/option><option value=\"Mbandaka\">Mbandaka<\/option><option value=\"\"><\/option><option value=\"- - HAUT-KATANGA - -\">- - HAUT-KATANGA - -<\/option><option value=\"Kasumbalesa\">Kasumbalesa<\/option><option value=\"Kasumbalesa - Wiski\">Kasumbalesa - Wiski<\/option><option value=\"Kilwa\">Kilwa<\/option><option value=\"Likasi\">Likasi<\/option><option value=\"\"><\/option><option value=\"- - HAUT-LOMAMI - -\">- - HAUT-LOMAMI - -<\/option><option value=\"Kamina\">Kamina<\/option><option value=\"\"><\/option><option value=\"- - ITURI - -\">- - ITURI - -<\/option><option value=\"Bunia\">Bunia<\/option><option value=\"\"><\/option><option value=\"- - KASA\u00cf-CENTRAL - -\">- - KASA\u00cf-CENTRAL - -<\/option><option value=\"Kananga\">Kananga<\/option><option value=\"\"><\/option><option value=\"- - KASA\u00cf-ORIENTAL - -\">- - KASA\u00cf-ORIENTAL - -<\/option><option value=\"Mbuji-Mayi\">Mbuji-Mayi<\/option><option value=\"\"><\/option><option value=\"- - KONGO-CENTRAL - -\">- - KONGO-CENTRAL - -<\/option><option value=\"Boma\">Boma<\/option><option value=\"Matadi\">Matadi<\/option><option value=\"Matadi - Port Sec Aidel-Ticom\">Matadi - Port Sec Aidel-Ticom<\/option><option value=\"Muanda\">Muanda<\/option><option value=\"\"><\/option><option value=\"- - KWANGO - -\">- - KWANGO - -<\/option><option value=\"Kenge\">Kenge<\/option><option value=\"\"><\/option><option value=\"- - KWILU - -\">- - KWILU - -<\/option><option value=\"Bandundu\">Bandundu<\/option><option value=\"Kikwit\">Kikwit<\/option><option value=\"\"><\/option><option value=\"- - LOMAMI - -\">- - LOMAMI - -<\/option><option value=\"Kabinda\">Kabinda<\/option><option value=\"Mwene-Ditu\">Mwene-Ditu<\/option><option value=\"\"><\/option><option value=\"- - LUALABA - -\">- - LUALABA - -<\/option><option value=\"Fungurume\">Fungurume<\/option><option value=\"Kolwezi\">Kolwezi<\/option><option value=\"Kolwezi - TMB Plus\">Kolwezi - TMB Plus<\/option><option value=\"Kolwezi - DRLU\">Kolwezi - DRLU<\/option><option value=\"\"><\/option><option value=\"- - MANIEMA - -\">- - MANIEMA - -<\/option><option value=\"Kindu\">Kindu<\/option><option value=\"\"><\/option><option value=\"- - NORD-KIVU - -\">- - NORD-KIVU - -<\/option><option value=\"Beni\">Beni<\/option><option value=\"Butembo\">Butembo<\/option><option value=\"Goma\">Goma<\/option><option value=\"Goma - TMB Plus\">Goma - TMB Plus<\/option><option value=\"Goma - Ihusi\">Goma - Ihusi<\/option><option value=\"Goma - Jambo Safari\">Goma - Jambo Safari<\/option><option value=\"Goma - Mairie\">Goma - Mairie<\/option><option value=\"Goma - Ihusi H\u00f4tel\">Goma - Ihusi H\u00f4tel<\/option><option value=\"Goma - Grande Barri\u00e8re 1\">Goma - Grande Barri\u00e8re 1<\/option><option value=\"Logu\">Logu<\/option><option value=\"\"><\/option><option value=\"- - NORD-UBANGI - -\">- - NORD-UBANGI - -<\/option><option value=\"Gbadolite\">Gbadolite<\/option><option value=\"\"><\/option><option value=\"- - SANKURU - -\">- - SANKURU - -<\/option><option value=\"Lodja\">Lodja<\/option><option value=\"\"><\/option><option value=\"- - SUD-KIVU - -\">- - SUD-KIVU - -<\/option><option value=\"Bukavu\">Bukavu<\/option><option value=\"Bukavu - Panorama H\u00f4tel - TMB Plus\">Bukavu - Panorama H\u00f4tel - TMB Plus<\/option><option value=\"Bukavu - ISP\">Bukavu - ISP<\/option><option value=\"Bukavu - Panzi\">Bukavu - Panzi<\/option><option value=\"Bukavu - DGDA\">Bukavu - DGDA<\/option><option value=\"Uvira\">Uvira<\/option><option value=\"\"><\/option><option value=\"- - SUD-UBANGI - -\">- - SUD-UBANGI - -<\/option><option value=\"Gemena\">Gemena<\/option><option value=\"\"><\/option><option value=\"- - TANGANYIKA - -\">- - TANGANYIKA - -<\/option><option value=\"Kalemie\">Kalemie<\/option><option value=\"Manono\">Manono<\/option><option value=\"\"><\/option><option value=\"- - TSHOPO - -\">- - TSHOPO - -<\/option><option value=\"Kisangani\">Kisangani<\/option><option value=\"\"><\/option><option value=\"- - GUICHETS PEPELE MOBILE - -\">- - GUICHETS PEPELE MOBILE - -<\/option><option value=\"Lubumbashi cadastre\">Lubumbashi cadastre<\/option><option value=\"Kinshasa Egal Barumbu\">Kinshasa Egal Barumbu<\/option><option value=\"Kinshasa Egal UPN\">Kinshasa Egal UPN<\/option><option value=\"Goma cadastre\">Goma cadastre<\/option><option value=\"\"><\/option><option value=\"- - GUICHETS POLICE ET ARM\u00c9E - -\">- - GUICHETS POLICE ET ARM\u00c9E - -<\/option><option value=\"- LUBUMBASHI -\">- LUBUMBASHI -<\/option><option value=\"Camp Bel Air\">Camp Bel Air<\/option><option value=\"PNC - Ville\">PNC - Ville<\/option><option value=\"- KINSHASA -\">- KINSHASA -<\/option><option value=\"EMG1\">EMG1<\/option><option value=\"EMG2\">EMG2<\/option><option value=\"Tshatshi\">Tshatshi<\/option><option value=\"Camp Kokolo\">Camp Kokolo<\/option><option value=\"Circo\">Circo<\/option><option value=\"Camp Lufungula\">Camp Lufungula<\/option><option value=\"LNI\">LNI<\/option><option value=\"Camp Kabila\">Camp Kabila<\/option><option value=\"Ceta\">Ceta<\/option><option value=\"Kibomango\">Kibomango<\/option><option value=\"Maluku\">Maluku<\/option><option value=\"- HAUT-LOMAMI -\">- HAUT-LOMAMI -<\/option><option value=\"Camp militaire Kamina\">Camp militaire Kamina<\/option><option value=\"- KONGO-CENTRAL -\">- KONGO-CENTRAL -<\/option><option value=\"Muanda - Base de Kitona\">Muanda - Base de Kitona<\/option><option value=\"Mbanza-Ngungu\">Mbanza-Ngungu<\/option><option value=\"- SUD-KIVU -\">- SUD-KIVU -<\/option><option value=\"Bukavu - PNC Bukavu\">Bukavu - PNC Bukavu<\/option><option value=\"\"><\/option><option value=\"- - GUICHETS CORPORATE - -\">- - GUICHETS CORPORATE - -<\/option><option value=\"Kamoa\">Kamoa<\/option><option value=\"Logu\">Logu<\/option><option value=\"\"><\/option><option value=\"AUTRE (Veuillez pr\u00e9ciser)\">AUTRE (Veuillez pr\u00e9ciser)<\/option><\/select><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<div data-id=\"group-885\" data-orig_data_id=\"group-885\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label class=\"cf7-field\"><br \/>\n<span class=\"cf7-label\">Veuillez pr\u00e9ciser <em>*<\/em><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"autre\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required cf7-input\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"autre\" \/><\/span><br \/>\n<\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-actions\">\n\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner cf7-submit\" type=\"submit\" value=\"Envoyer\" \/>\n\t\t<\/p>\n\t<\/div>\n\t<p class=\"cf7-note\"><strong>*<\/strong> R\u00e9ponse obligatoire\n\t<\/p>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n            <\/div>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Claim Form Nom * Postnoms * Pr\u00e9noms * T\u00e9l\u00e9phone * E-mail * Avez-vous un compte TMB ? OuiNon Num\u00e9ro de compte 00017 Cette r\u00e9clamation concerne (un seul choix possible): Carte bancaireCh\u00e8ques et OPCoffre-fortCommunication\/publicit\u00e9Cr\u00e9dit entrepriseCr\u00e9dit particulierCr\u00e9dit salari\u00e9Cr\u00e9doc et remise documentaireD\u00e9p\u00f4t\/retraitDistributeur de billets (DAB-ATM)FOREXGestion des comptesInstitution financi\u00e8reInstitution internationaleLicence bancaireNetBankPaie des fonctionnairesPaiement fournisseursPEPELE Mobile Agent ind\u00e9pendantPEPELE Mobile ClientPEPELE [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-16492","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Claim Form - TMB<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.tmb.cd\/en\/claim-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Claim Form - TMB\" \/>\n<meta property=\"og:description\" content=\"Claim Form Nom * Postnoms * Pr\u00e9noms * T\u00e9l\u00e9phone * E-mail * Avez-vous un compte TMB ? 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