| Agency name | * |
| Company name | * |
| Country | |
| Headquarters | * (County, City, Street, Nr, Zip) |
| Tourism licence | * |
| Valid until | *
Doesn't expire |
| Administrator name | *
(First and last name) |
| Working point |
(County, City, Street, Nr, Zip) (Copy from Headquarters) |
| Registration code | * |
| Trade Register Nr. | * |
| of | * |
| Account RON | * |
| Account EUR | * |
| Bank name | * |
| Subsidiary | * |
| Phone nr | * |
| Fax | |
| User: |
* Allowed characters a - z, A - Z, 0 - 9, maxim of 25 chars, no spaces. |
| E - mail: | * |
| Password: | minimum password length: 5 characters. |
| Retype password: |
When password is not completed will be genrated random. |
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