Costumer Registration
Company Name (Ragione Sociale)
Your answer
Date (Data)
MM
/
DD
/
YYYY
Contact (Contatto)
Your answer
Address (Indirizzo)
Your answer
Billing Name and Address "if different" (Indirizzo Sede Amministrativa "se diverso")
Your answer
Your Email address to receive DX invoices (Email per invio nostra Fatturazione)
Your answer
Telephone number (Telefono)
Your answer
Bank (Banca)
Your answer
Vat number (P. IVA)
Your answer
Swift and Bic Number (IBAN e RIBA)
Your answer
Terms of payment (Condizioni di Pagamento)
Your answer
Preferred Courier (Trasportatore Preferenziale)
Your answer
Hold for Pick-Up (Fermodeposito)
Shipping (Spedizione)
Submit
Never submit passwords through Google Forms.
This form was created inside of ditex. Report Abuse - Terms of Service - Additional Terms