Company name *

VAT *

Trade Register *

City *

Contact: First name / surname *

Telephone/fax *

E-mail

Country of load Austria Belgia Bulgaria Cehia Danemarca Elvetia Franta Germania Grecia Luxemburg Marea Britanie Norvegia Olanda Polonia Portugalia Romania Spania Solvacia Slovenia Ungaria *

Another country

City *

Date of loading *

Destination Austria Belgia Bulgaria Cehia Danemarca Elvetia Franta Germania Grecia Luxemburg Marea Britanie Norvegia Olanda Polonia Portugalia Romania Spania Solvacia Slovenia Ungaria *

Another country

City destination *

Type of goods transported *

ADR Yes No

FRIG Yes No

Volume ( cm )

Weight ( kg )

Package size (lenght x width x height)

Transport type Partial Full

Special remarks