Registration form for the EKO-KOM system for companies established in other EU Member States

This registration form is only for companies established in EU Member States, if your company is established outside the EU (for example China), please use this Registration form.

Data for the contract

VAT No.*

Company name*

Registered office (place of business)

Street*

No.*

City*

Postal code*

State*

The Company has at the above mentioned address its registered seat

YES

NO, only fixed establishment

Please register your company under your register seat (stated in business register).

The Company declares that all the above mentioned statements are accurate. Further, the Company undertakes to inform EKO-KOM, a.s. within 10 days if any of the above mentioned statements change. The Company will, without any delay, additionally pay the VAT based on the received corrective tax documents and indemnify EKO-KOM, a.s. for any damage (e.g., penalties and late payment interest assessed by the Czech tax authorities) caused by invalidity of this Affirmation or by failing in its information obligation.

Represented by (Statutory Representative)

(person who signs the contract)

Name*

Surname*

Name

Surname

Name

Surname

Name

Surname

Name

Surname

The contract will be sent to the email address of the contact person listed below for qualified electronic signature. Please attach a document proving the authority is authorised to act on behalf of the company and sign the contract (for example a copy of an extract form the business register). In case your company will be represented by another company / person, please attach a Power of Attorney.

Document proving the authority is authorised
(to act in behalf of the company and sign the contract) or Power of Attorney