1.4.b form: 1.5 Address of registered company seat: 1.6 Address of head office (if different from 1.4 above): 1.7 Postal address: 1.8 Telephone number: 1.9 Fax number: 1.10 E-mail: 1.11 Firm’s website: 1.12 Representatives of the applicant in respect of this application 1.12.1 Representative 1 1.12.1.1 Full name: 1.12.1.2 Position/relationship with applicant: 1.12.1.3 Business address: 1.12.1.4 Postal address: 1.12.1.5 E-mail: 1.12.1.6 Telephone number: 1.12.1.7 Fax number: 1.12.2 Representative 2:
1.4.b form: 1.5 Address of registered company seat: 1.6 Address of head office (if different from 1.4 above): 1.7 Postal address: 1.8 Telephone number: 1.9 Fax number: 1.10 E-mail: 1.11 Firm’s website: 1.12 Representatives of the applicant in respect of this application 1.12.1 Representative 1 1.12.1.1 Full name: 1.12.1.2 Position/relationship with applicant: 1.12.1.3 Business address: 1.12.1.4 Postal address: 1.12.1.5 E-mail: 1.12.1.6 Telephone number: 1.12.1.7 Fax number: 1.12.2 Representative 2:
ECA_118_ANNEX_I.docx