NAME OF THE CUSTOMER AND THE INITIATOR OF SERVICE |
Date / Time / IP | 18.05.2025 00:51:58 / 18.117.155.120 |
*Customer
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The initiator of service |
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INFORMATION ABOUT PAYER: |
Legal status |
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Country |
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*Company registration number
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*Tax bearer registration number
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Check VAT
No in EU
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Adress |
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Bank name: |
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SWIFT Code: |
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Account number or (IBAN): |
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If you use another bank identiication code, enter that code. |
Bank code: |
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Correspondent account: |
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Payment account: |
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Phone number |
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Fax |
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e-mail |
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INFORMATION ABOUT OBJECT: |
Type of transport vehicle | |
Type of vehicle |
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Mark |
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Model |
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State registration number |
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Date of manufacturing |
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Model year |
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First registration date |
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Colour |
Metallic: |
Number of the registration certificate |
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VIN (Vehicle identification number) |
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Inspection place |
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Departure to inpection place fee
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Notes |
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The customer is informed that: 1. The payer pays 0.00 EUR in full and payment terms specified in the payment document. 2. Period of validity of the payment document is 3 days. 3. The document stands out in one copy. The document copy can be received for additional payment within 10 days after reception of the document original. 4. The executor does not bear responsibility for defects which cannot be found out by application of organolepthic method and the left things (subjects). 5. The executor does not bear responsibility for errors admitted by the Customer at order registration. 6. By the payment of invoice the Customer agrees to processing of his personal data. |
Agree |
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Enter the control code: |
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(Latin letters) |
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Tools |
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*Fields, obligatory for filling |