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CONTACT PERSON:*

SHOP NAME:*

COMPANY DETAILS

COMPANY NAME:*

TAX CODE:*

VAT NUMBER:*

ADDRESS:*

CITY and PROVINCE:*

ZIP CODE:*

COUNTRY:*

PHONE:*

MOBILE:*

FAX:

EMAIL:*

WEBSITE:

EMAIL FOR INVOICES:*

ADDRESS:

CITY:

ZIP CODE:

COUNTRY:

PHONE:

MOBILE:

FAX:

BANK NAME:*

IBAN (EU) / ROUTING NUMBER (EXTRA EU) – SWIFT / BIC CODE – ACCOUNT HOLDER:*

SDI CODE:

COMPANY ESTABLISHED SINCE:

DEPARTMENT / INDEPENDENT / OTHER:

SHOP AREA SQMT:

NUMBER OF WINDOWS:

SALE PEOPLE EMPLOYED:

STORE LOCATION:*

BRANDS IN SHOP: PLEASE SPECIFY 4 SHOES BRANDS, 6 CLOTHING BRANDS AND 2 ACCESSORIZE BRAND:*

BRANDS OF INTEREST:*

HOW DID YOU GET IN TOUCH WITH SLAM JAM:

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