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Customer Contact Information

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* Pole wymagane

Company

VAT number *
Name *
Adress *
City *
State
Zipcode *
Country *

Sales

Contact person *
Business phone *
Mobile phone
E-mail - Sales *
Skype name
Website

Invoice to be sent to

(Choose E-mail or fax)

E-mail - invoice

If you use own carrier please state name, phone no. and contact person

Carrier name
Contact person
Phone
E-mail - carrier

Delivery adress

(if different from company address)

Name
Adress
City
State
Zipcode
Country

Accounts department

Contact person *
Business phone *
Mobile phone
E-mail - accounts *
Skype name

Order confirmation to be sent by

(Choose E-mail or fax)

E-mail - order