Name*

Warranty Card no*

Surname*

Date of purchase*

Company name*

E-mail adress*

Phone number*

Location of the installation site:

Company name:

Contact phone number*:

Contact person at the location*:

Address*:

Contact person e-mail*:

I agree to the processing of my personal data in accordance with the law on the protection of personal data in connection with (eg the implementation of the application). Providing the data is voluntary, but necessary to process the query. I have been informed that I have the right to access my data, the possibility of correcting it, requesting discontinuation of its processing. The administrator of personal data is Gastop Production Sp. z o.o. with registered office at ul. Krakowska 229, 32-080 Zabierzów.