Full name of the company

Full name of contact person

Postal code

Place

Street, house number

Phone

Fax

Email

NIP (Tax Identification Number)

REGON

Number given by the National Court Register (KRS) or records of economic activity

License number of road carrier

Which countries do you drive?

 National transport  Germany, Netherlands, Belgium  Denmark  Czech Republic, Slovakia  Hungary  Austria  Sweden  Finland  Norway  France  Spain  Portugal  Great Britain  Ireland  Italy  Latvia, Lithuania, Estonia  Southern Europe (countries of former Yugoslavia, Romania, Bulgaria, Greece, etc.)  Russia, Belarus, Ukraine

What vehicles do you own?

 Standard semi-trailers  Mega semi-trailers – 100 m³  Sets – 117m³  Refrigarators  Others (please specify)

The MEXEM Department to which you would like to address a question:

PruszkówMiastkoKowalewiceSuwałki