e-form

Aloaha Blockchain Testform

Fields marked as authenticated will be filled automatically by the Blockchain based eID Services.

Issue date





Title





Authenticated Name



Payment Subject







Authenticated Surname





Authenticated Mobile





Authenticated E-mail





Custom E-mail






With the up- and download button you can save/retrieve your personal into the Blockchain. All personal data is double encrypted with your public key.







If you click on the yellow "V" Button you pay the specified amount to the form owner. A transaction number will be displayed at the bottom of the form.





Coins





Payment Recipient





You can draw a simple electronic signature on the signature field. Additionally this form will be digitally signed with your private key on submission.





Simple touch Signature





Kindly also have a look at Testform "Blockchain"

Transaction ID







Print Form Submit Form


 


Aloaha Software
Aloaha Form Provider