Dealer Registration

Place here your text.

Company

Company name:

Registration number Chamber of Commerce:

Address:

Zip code:

Town:

State:

Country:

Telephone number:

Fax number:

Email address:

Website / URL:


Financial details

Tax number:

Bank:

Adress:

Bank account number:


Other company details

How many square meters is your company:

the showroom measures:

How many employees does your company have?

Mechanics:

Sales persons:

How much revenue of Mosselman Turbo Systems products do you expect annually?

0 - 15.000 euro

15.000 - 40.000 euro

over 40.000 euro

Do you represent other brands in the automotive sector, if yes, which?

No

Yes,

Do you have any experience with programming enginemanagement systems?

No

Yes,

Town:

Date:

Initials and surname:


Signing

Town:

Initials and surname:

Date: