Customer registration

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Your company data

For the processing of your spare parts requests we need some information. Please fill out the following form once as completely as possible. Please understand that it is not possible for us to process your spare parts inquiry without knowing your company data.

Company details

Company*

Salutation

First Name*

Last Name*

Street*

Zip code*

City*

Country*

State

Email Address*

Phone

Fax

VAT identification number

Please mark with a cross

Repair shop
Dealer
Vehicle manufacturer / OEM
End user

Other remarks

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Your message to us is transmitted via SSL encrypted. Your IP address and the date and time of the request will be transferred to the e-mail. Your data will be treated confidentially. We store them exclusively for the purpose of contacting you and do not pass them on to third parties.

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Customer registration

Customer registration

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Your company data

COMPANY

PRODUCTS

Postal address

Delivery address

Human Resources

Sale

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