Do you consider that the danger to be declared is serious? * Yes no Report a damage on the network Types of equipment concerned: Select an option The information which follows is intended to enable you to follow the progress of this signaling, or for a technician to contact you concerning this signaling. By validating this form you signify your consent to the use of your personal data. Your personal data will not be used for commercial or advertising purposes. Depositor information Last name and first name: Nature of the depositor: Local community Deposit as: Other Mail address: Telephone: Is the depositor the same person as the victim of the damage ?: Yes no The references appearing on the damaged book can help us to intervene quickly. Please provide us with a photo of the damage. Choose / Take a photo *: Choose / Take a photo: Remark: 0 /200 Address / Place of damage Address: GPS coordinates: Burgem. Stanislas De Rijcklaan 34, 3001 Leuven, Belgium coordinates: 50.865766,4.698931 Captcha Send