H-Way

Customer No.0006250874

Gender*

Customer Type*

Business Name

First Name*

Last Name*

Fiscal Code

Birth Date

Age

Salutation

Purpose of buying this car*

Passport No.

Country

Issue Date

Release Body

ID(Email)

Date of Registered

Date of Withdrawal

I give my consent to use my personal information for marketing.(I agree / 31-Jan-20)

I give my consent to use my personal information for market research purposes.(I do not agree / 31-Jan-20)

Phone**

Mobile**

Email*

Search Address

Address

Street Number

Postcode

City

Rest of address

Region

Country

*Mandatory fields must be filled

**One of the mandatory fields must be filled

Prefer Communication

Y NPersonal Data Processing*

The customer has been informed with the processing of personal data

Y NMarketing Consent Agreement*

Y NCustomer Profiling*

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