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| Country * |
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| Name * |
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| Surname * |
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| Gender |
Male
Female |
| Company |
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| Vat no. |
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| Identification no. |
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| Address * |
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| City * |
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| Postcode * |
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Telephone * |
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| Mobile |
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| Fax |
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| Email address * |
(this will become your userid) |
| Website |
http://
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Se intendete registrarvi come rivenditori occorre inviare via fax al numero 0734.605057 o all'email info@minimotophantom.it i seguenti dati:
- Certificato Camera di Commercio
- Indirizzo e foto del vostro negozio
Nel campo Comments potete anticipare queste informazioni.
Vi ricordiamo che Phantom srl fornisce la rivendita esclusiva per una o
più province.
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| Comments |
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| Secret question * |
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| Secret answer * |
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| Personal data protection: |
We inform you that your personal data will be used solely and exclusively by Phantom srl and will not be passed on to third parties without your prior consent in accordance with Italian law 196/2003.
(Read all the information) |
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* In accordance with Italian law 196/2003, I authorise the use of my personal data. |
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