Registration Form for the EKO-KOM System

Data for the contract

Company ID

VAT No.*

Company name*

If you do not have a Czech VAT No., please fill in a VAT Affirmation for EU clients or non-EU clients.

Affirmation about VAT (doc, docx, pdf)

Registered office (place of business)

Street*

No.*

City*

Postal code*

State*

Represented by (Statutory Representative)

(person who signs the contract)

Name*

Surname*

Name

Surname

Name

Surname

Name

Surname

Name

Surname

In case your company will be represented by another company / person, please fill in Power of Attorney.

Power of Attorney (doc, docx, pdf)

Czech data box identifier

Contact person

(person who fills in quarterly statements and communicates with EKO-KOM, a.s.)

Name*

Surname*

Correspondence address

Same address as Registred office (place of business)

Street*

No.*

City*

Postal code*

State*

Phone*

E-mail*

Other data

Website

E-mail for receiving invoices

IBAN

Choose the predominant business activity

Producer / Importer of packaged goods

Distributor of packaged goods

Retail business - seller to consumer (in predominant extent)

Producer / Importer of packaging means

Comment

Select the correctly rotated container*

I agree to the processing of personal data for the needs of EKO-KOM, a.s. *