Compiling it in all of his parts you will facilitate the operations to be contacted.
Name: Last name:
Reason Soc.: Address:
Zip: City:
Province: Telephone:
Cellular: E-mail:
Object:    
Notes:
  You have to consent the treatment of your personal data.

I declare to freely have taken action that the required personal data will be used me to the purpose to receive more specific information on the proposed service. Action that is recognized me the right to know take, to cancel, to correct, to adjourn, to integrate, to oppose me to the treatment of my personal data as well as to practice the other rights recognized by the art.7s, 10, 13 of the law 675/96