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Políčka označené * sú povinné.

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Do tohto políčka zadajte 8-ciferné číslo. Ak nepoznáte vaše zákaznícke číslo, zistíte ho
dvoma spôsobmi:

1. Na faktúre
2. Na karte (pozrite obrázok)

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This field is mandatory and must be filled in.

This field is mandatory and must be filled in.

This field is mandatory and must be filled in.

Podrobné údaje o požadovanej faktúre

Fakturačné obdobie (dd/mm/rrrr)*

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This field is mandatory and must be filled in.

This field is mandatory and must be filled in.

This field is mandatory and must be filled in.

This field is mandatory and must be filled in.

Začiarknite toto políčko pred odoslaním žiadosti o registráciu

Začiarknite toto políčko pred odoslaním žiadosti o registráciu *

This field is mandatory and must be filled in.

Zákaznícky servis euroShell Card si vyhradzuje právo kontaktovať vás v prípade, že sa vyskytnú pochybnosti v súvislosti s odoslaným formulárom.