Representation Registration

Please complete all required fields. Mandatory fields are marked with an asterisk (*).

We treat the data about your company and its employees confidentially. Our work processes comply with EU data protection regulations.

Company Data

Company Name *

Street and Number *

Postal Code *

City *

Country *

Phone *

Fax

Company Registration or Identification Number *

Company Tax Number *

Authorization to Operate

Company Email Address

Website

Full Name of the Authorized Representative *

Date of Birth of the Authorized Representative *

Place of Birth of the Authorized Representative *

Nationality of the Authorized Representative *

Phone Number of the Authorized Representative *

Email Address of the Authorized Representative *

Full Name of the Contact Person *

Phone Number of the Contact Person *

Email Address of the Contact Person *

Vehicle Type *

VOZILO DO 3,5t VOZILO IZNAD 3,5t

Select the representation services you wish to use *

Number of Drivers Covered by the Service *

1 - 2 3 - 5 6 - 10 11 - 25 26 - 50 51 - 100 101 -150 151 i više 151 - 200