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Auftrag

This form let you send to us order. However according to law you have to print it, sign and send by fax or mail. Order without signing is not obliged. Our partners and registered customers can send orders after loading directly from web site. To have acces to loading page you have to be at least one time our paying customer or our foreign partner.


Order type*


Payer
Name of company*
Country*
Zip code*
City*
Street*
Home No.*
Contact person*
Province
Telephone*	+ --
Fax*	+ --
E-mail*
Mobile phone*	+ -
NIP*
REGON*


Loading place
At customer
Other address
Company name
Contact person
Country
Zip code
City
Street
Home No.
Province
Telephone	+ --
Fax	+ --


Delivery place
At customer
Other address
Company name
Contact person
Country
Zip code
City
Street
Home No.
Province
Telephone	+ --
Fax	+ --


Other data
Loading date	day month year
Unloading date	day month year
Export custom clearance at
Import custom clearance at
Delivery payed by*
Carriage rate*
Custom clearance
Payment deadline*	day month year
Kind of commodity*
Number of packages *
Weight (kg)*
Volume (m3)*
Container dimensions*
Delivery terms
Insurance*
Insurance amount*
Extra instructions for delivery
Extra informations

*- this cells must be filled

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