|
Name/Surname*
|
| |
Daniel Lozano Borregón
|
|
Place of birth
|
| |
Madrid, Spain
|
|
Date of birth
|
| |
28/08/1982
|
|
Fiscal Code (Italy or 000000 if foreigner)
|
| |
000000
|
|
Email
|
| |
danlozan@ucm.es
|
| FISCAL DATA |
|
Name/Surname – Company
|
| |
Daniel Lozano Borregón
|
|
Address
|
| |
López de Hoyos 168 5D
Madrid, Madrid 28002
Spagna
Map It
|
|
VAT n. (only for company or University)
|
| |
I am not a company or University
|
|
Fiscal code (Italy of 000000 if foreigner)
|
| |
000000
|
|
Payment
|
| |
Carta di Credito
|
|
Carta di credito
|
| |
MasterCard
XXXXXXXXXXXX2060
|
|
Ordine
|
| |
| Prodotto |
Quantità |
Prezzo unitario |
Prezzo |
|
Registration fee (social dinner not included)
|
1 |
590,00 € |
590,00 € |
|
No
|
1 |
0,00 € |
0,00 € |
| |
Subtotale |
590,00 €
|
| |
Totale |
590,00 € |
|
|
