e-form

Ecoregistration

In terms of ACT XII of 2004 (Eco-Contribution Act)

Details of Applicant

Full Name of Applicant





I.D. Card Number





VAT Registration Number





Company No.





Mobile No.





Business Address

Door Number / Name of Building and Street Name





Locality





Post Code





Fixed Telephone





Mailing / Home Address

Door Number / Name of Building and Street Name





Locality





Post Code





e-Mail Address







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