Sale and delivery of live fish

New costumer information

Information

Company name: *

Address: *

Postal code: *

City: *

Contact name: *

Delivery address:

Contact

VAT number:

Yes

No

Health category:

VHS: 1

2

3

4

5

IHN: 1

2

3

4

5

Regi-number:

Phone: *

Fax:

Cell:

E-mail: *

Website:

Bank

Bank name:

BLZ:

Bank account number:

Bank ID code:

IBAN:

Commercial registry number:

Corporate form:

Limited company

Private limited company

Personal company:

Remarks: *