form template
Content
SHELL CUSTOMER REGISTRATION FORM FOR SHELL E-BOXES
ECOTAX and French, Spanish, Portugal and Liefkenshoek tunnel e-Toll System To order your e-boxes for Shell InterRoute Plus, please :
1
- Complete this Customer Registration Form and the e-Boxes Order - Complete and scan the mandate - Scan (pdf format) the certificate of incorporation of the company - Scan (pdf format) the vehicle registration document of vehicles you want to order e-boxes For more information on documents to be collected to activate ITR+ e-box, please read the tab "Documents collection". Send it back via email :
2
Sign, date and add your company stamp to the Appendix and send it back to us :
If you need assistance, please contact us at the following number : or by e-mail:
Company Name (legal entity) VAT registration nr Type of customer Delivery address for e-boxes
1 address per euroShell Card Customer number
euroShell Customer nr
(8 digits)
or
EORI number
ZIP CODE COUNTRY (Use the drop down menu) Title of contact Person (Use the drop down menu) First Name (of contact person) Office Phone number (without country code and area code) e-mail address of the contact person Average monthly spend on French Motorway Tolls
CITY
Position (of contact person) Last Name (of contact person)
GBP
OR
EURO
This is my first order for InterRoute Plus e-toll box with Shell This is NOT my first order for InterRoute Plus e-toll box with Shell
Company Stamp : Date : Signature : 07/03/14
Signee Name :
By signing this document, you recognize that you read, understood and accepted the Appendix Shell InterRoute joined to the present document or consultable on our website www.euroshell.com. In order for us to send you the e-boxes, you'll need to return to the Shell address written on top of this document the Appendix signed and stamped.
Registered in England and Wales Company Registration. Number: 3625633 Registered office: Shell Centre, London, SE1 7NA
SHELL CUSTOMER REGI
ECOTAX and French, Spanish
Vehicle information
Contract information
Mandatory Mandatory Mandatory Mandatory Mandatory Optional
Mandatory
Mandatory
Mandatory
Mandatory
Nr of badges
Type of Equipement
Use the drop down menu.
Vehicle Country
Use the drop down menu. For further information, please refer below to the table named "Vehicle category"
Vehicle License Plate
As indicated on the vehicle certificate (with or without spaces and or dash)
Min Number of Axles Truck
Our advice is to indicate 2 by default. This data will be used for the set up of the badge.
Vehicle Min Number of Registration Date Axles Trailer (dd/MM/yyyy)
Vehicle Emission
EEV
Use the drop down menu
Gross Vehicle Weight Rating
Field F2 of the vehicle certificate or field F1 if F2 is blank
Authorized Gross Vehicle Weight
Field F3 of the vehicle certificate. If blank, please indicate the same weight than in field "Gross Vehicle Weight Rating"
Our advice is to Exact date on the vehicle Use the drop indicate 3 by default. certificate or leave it down menu This data will be used blank for the set up of the badge.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR
BA BA BA BA BA BA BA BA BA BA BA BA BA
A78-J-751 T64-T-688 A05-T-735 403-J-478 O28-T-352 943-T-374 O28-T-353 E09-T-011 T42-M-638 J81-O-196 A03-K-884 M81-J-168 K67-E-004
2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3
Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5
No No No No No No No No No No No Yes No
20100 18000 18000 18000 18000 19000 18000 18000 18000 18000 18000 18000 18000
20100 18000 18000 18000 18000 19000 18000 18000 18000 18000 18000 18000 18000
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62
63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179
180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200
CUSTOMER REGISTRATION FORM FOR SHELL E-BOXES
and French, Spanish, Portugal and Liefkenshoek tunnel e-Toll System
Delivery Address
Mandatory Mandatory Mandatory Optional : have to be filled if the badges have to be delivered to another address
Renting Compan
Optional (Mandatory if Owner of the vehicl
European Vehicle Category
Use the drop down menu. For further information, please refer below to the table named "Vehicle category"
Vehicle Type
Owner of the vehicle
Delivery Contact Title
Use the drop down menu
Delivery Contact LastName
Delivery Contact FirstName
Delivery Contact Street
Delivery Contact Addres Complement
Delivery Contact ZIP
Delivery Contact City
Delivery Contact Country
Use the drop down menu
Renting Company Name
Renting Company Steet
Use the drop down Use the drop menu : down menu : HGV = Truck LGV = Tis VL only C = You are the owner R = Vehicle is rented
N3 N3 N3 N3 N3 N3 N3 N3 N3 N3 N3 N3 N3
HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV
C C C C C C C C C C C C C
Renting Company information
Mandatory
Mandatory if Owner of the vehicle = 'R')
Zip Code Renting Company
City Renting Company
Country Renting Company
Use the drop down menu
VAT ID Renting Company
TISPL InterRoute TISVL ECOTAX + TISPL ECOTAX + TISPL + ITR
AL AD AT BA BE BG BY CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IT LT
LU LV MD MK NL NO PL PT RO RS RU SE SI SK TR UA
TAXE POIDS LOURDS
MANDAT POUR LA DECLARATION DU VEHICULE ET LE PAIEMENT DE LA TAXE Entreprise (raison sociale, adresse) :
Je soussigné (NOM, Prénom) : Agissant en qualité de : 0 dument habilité(e) aux fins des présentes
Donne par la présente, mandat à AXXES SAS située à Tour Oxygène, 10-12 bd Vivier Merle, 69393 LYON CEDEX 03 – France, agissant en qualité de Société Habilité de Télépéage Pour déclarer mon (mes) véhicule(s) à l’enregistrement pour mon compte et me désigner comme redevable enregistré ainsi que pour acquitter la taxe due au titre de la taxe poids lourds en mon nom et pour mon compte. J’atteste avoir fourni à AXXES SAS, des pièces justificatives valides afin de procéder à l’enregistrement de mon (mes) véhicule(s). Ainsi je me porte garant de l’exactitude et de la véracité des dites pièces au regard de la réglementation applicable. Je déclare ne pas être lié contractuellement auprès d’une société tierce pour les services cités ci-dessus, ou, le cas échéant, avoir effectué toutes les opérations de résiliation pour tout autre contrat d’abonnement contracté pour ces services auprès d’une société tierce. Je souhaite recevoir les détails de liquidation et donne, par la présente, mandat à Axxès pour solliciter en mon nom et pour mon compte les détails de liquidation.
Qualité du signataire (ou de la société représentée par le signataire) au regard du (des) véhicule(s)
Liste des véhicules concernés par le présent mandat
Genre National
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Souslocataire
Propriétaire
N° IMMATRICULATION A78-J-751 T64-T-688 A05-T-735 403-J-478 O28-T-352 943-T-374 O28-T-353 E09-T-011 T42-M-638 J81-O-196 A03-K-884 M81-J-168 K67-E-004
ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
X X X X X X X X X X X X X
Fait à , le
07/03/14
Faire précéder la signature de la mention « Bon pour mandat », et apposer le cachet de l’entreprise
Locataire
PAYS D’IMMATRICULATION
Utilisateur
Axxès SAS au capital de 7.500.000,00 Euros Tour oxygène 10-12 Bd Vivier Merle 69393 LYON CEDEX 03 RCS Lyon 482 930 385 N° TVA : FR40482930385
For information only, do not fill in the English version
HEAVY GOOD VEHICLES TAX
MANDATE FOR THE REGISTRATION OF VEHICLES AND PAYMENT OF THE TAX Company name and address: I the undersigned [Last name, First name] : Acting as : duly authorized for the purpose of this mandate
Grants by this letter, mandate to AXXES SAS located Tour Oxygène, 10-12 bd Vivier Merle, 69393 LYON CEDEX 03 – France, acting as SHT (Société Habilité de Télépéage – Approved Electronic Toll Company) To declare my vehicle(s) for registration on my behalf and nominate me as the liable registered person as well as paying the tax applicable to the heavy good vehicles in my name and for my account. I hereby confirm that I have given to AXXES SAS, valid supporting documents in order to proceed registration of my vehicle(s). Thereby, I am answerable for the accuracy and veracity of the documents in light of the applicable regulation. I declare not being contractually bound to a third party supplier for the above described services, or, if required, having conducted all necessary actions for the termination of any other subscription contract taken for the above services to a third party supplier. I wish to receive the detail of tax assessments and give, by this letter, mandate to AXXES SAS, to obtain on my behalf and my account the assessment details.
Description of the signatory (or the company represented by the signatory) in view of the vehicles(s)
List of vehicle affected by the present mandate
National Gender Vehicle Registration Number (VRN)
Rentee
Owner
Done at …………………. on .… / …. / …….
Before the signature, please hand-write « Bon pour mandat », and stamp it with the stamp of your company
Axxès SAS au capital de 7.500.000,00 Euros Tour oxygène 10-12 Bd Vivier Merle 69393 LYON CEDEX 03 RCS Lyon 482 930 385 N° TVA : FR40482930385
User
Vehicle Registration Country
Sub rentee
des présentes
385
385
Object >> Redevable / beholden Redevable category (by default, for Ecomouv, the beholden Is the name on the vehicle registration certificate) Owner or Leased vehicle (for less than 3 months) Tenant of the vehicle (for more than 3 months) or Sub-tenant (for more than 3 months) User
Redevable / beholden
Certificate of incorporation
Mandate
Company
Mandatory
Mandatory
Additional information
AT proof, EORI proof, proof of company registration to the chamber of commerce or proof of association creation
Please find some recommendations to transfer documents :
- You remain responsible of documents until they come to Shell - Always use a encrypted format using WINZIP, before sending it to Shell - Whatever is the sending format (email, USB key, CDROM), send password separately from the winzip fi See below the process :
Sending a ZIP file with encryption
Store the file on a location. Go to the location and right click on the file. Chose the option – Send to -> Compressed (zipped) Folder
A Zip file will be created with the same name as the original file. Open the Zip file by double clicking:
Choose the option Encrypt in the menu icons:
Below screen will appear that allows you to enter a password (2x)
Please ensure the encryption type is set to 256-Bit AES encryption:
Click on OK
The file name will now show it is encrypted as the file has a * – Example.txt*
The Zip file can now be attached to an e-mail and send to the receiver.
Vehicle
Vehicle registration certificate
Certificate of conformity (COC)
CEMT authorization
- If no proof document for axle: number of axle will be considered as "4 and +" by Ecomouv. Mandatory - If no proof document for EURO class: Ecomouv' will use the most unfavourable Euro class.
Out of UE: At least one of this 3 documents must be provided with the Vehicle registration certificate.
ely from the winzip file
e
Manufacturer certificate
Leasing/rental contract
Outsourcing contract
f axle will be considered as "4 and +" ouv. Mandatory
mouv' will use the most unfavourable ss.
Mandatory
Mandatory if name of the Mandatory if name of the ts must be provided with the Vehicle company is not the one company is not the one rtificate. mentioned on Vehicle mentioned on Vehicle registration certificate. registration certificate.
Type of vehicle code
A L M1 M2 M3 N1 N2 N3 I
Other Motor vehicles with two or three-wheel and four motor Vehicles designed and constructed for carrying 9 passengers included the driver Vehicles designed and constructed for carrying more than 9 passengers included the driver and h Vehicles designed and constructed for carrying more than 9 passengers included the driver and h Vehicles designed and constructed for the transport of goods and having a maximum mass not e Vehicles designed and constructed for the transport of goods and having a maximum mass betwe Vehicles designed and constructed for the transport of goods and having a maximum mass excee Not known
Vehicle Country Code
ALBANIA ANDORRA AUSTRIA BÉLARUS BELGIUM BOSNIA BULGARIA CROATIA CYPRUS CZECH REPUBLIC DENMARK ESTONIA FINLAND FRANCE GERMANY GREECE HUNGARY IRELAND ITALY LATVIA LITUANIA LUXEMBURG MACÉDOINE MOLDOVIA NETHERLANDS NORWAY POLAND PORTUGAL ROMANIA RUSSIA SERBIA SLOVAKIA SLOVENIA SPAIN SWEDEN AL AD AT BY BE BA BG HR CY CZ DK EE FI FR DE GR HU IE IT LV LT LU MK MD NL NO PL PT RO RU RS SK SI ES SE
SWITZERLAND TURKEY UKRANIA UNITED KINGDOM
CH TR UA GB
Definition
Other Motor vehicles with two or three-wheel and four motor Vehicles designed and constructed for carrying 9 passengers included the driver Vehicles designed and constructed for carrying more than 9 passengers included the driver and having a maximum mass not e Vehicles designed and constructed for carrying more than 9 passengers included the driver and having a maximum mass exce Vehicles designed and constructed for the transport of goods and having a maximum mass not exceeding 3,5 tonnes. Vehicles designed and constructed for the transport of goods and having a maximum mass between 3,5 and 12 tonnes. Vehicles designed and constructed for the transport of goods and having a maximum mass exceeding 12 tonnes. Not known
Comments
Coach companies are not liable for Ecotax
ECOTAX and French, Spanish, Portugal and Liefkenshoek tunnel e-Toll System To order your e-boxes for Shell InterRoute Plus, please :
1
- Complete this Customer Registration Form and the e-Boxes Order - Complete and scan the mandate - Scan (pdf format) the certificate of incorporation of the company - Scan (pdf format) the vehicle registration document of vehicles you want to order e-boxes For more information on documents to be collected to activate ITR+ e-box, please read the tab "Documents collection". Send it back via email :
2
Sign, date and add your company stamp to the Appendix and send it back to us :
If you need assistance, please contact us at the following number : or by e-mail:
Company Name (legal entity) VAT registration nr Type of customer Delivery address for e-boxes
1 address per euroShell Card Customer number
euroShell Customer nr
(8 digits)
or
EORI number
ZIP CODE COUNTRY (Use the drop down menu) Title of contact Person (Use the drop down menu) First Name (of contact person) Office Phone number (without country code and area code) e-mail address of the contact person Average monthly spend on French Motorway Tolls
CITY
Position (of contact person) Last Name (of contact person)
GBP
OR
EURO
This is my first order for InterRoute Plus e-toll box with Shell This is NOT my first order for InterRoute Plus e-toll box with Shell
Company Stamp : Date : Signature : 07/03/14
Signee Name :
By signing this document, you recognize that you read, understood and accepted the Appendix Shell InterRoute joined to the present document or consultable on our website www.euroshell.com. In order for us to send you the e-boxes, you'll need to return to the Shell address written on top of this document the Appendix signed and stamped.
Registered in England and Wales Company Registration. Number: 3625633 Registered office: Shell Centre, London, SE1 7NA
SHELL CUSTOMER REGI
ECOTAX and French, Spanish
Vehicle information
Contract information
Mandatory Mandatory Mandatory Mandatory Mandatory Optional
Mandatory
Mandatory
Mandatory
Mandatory
Nr of badges
Type of Equipement
Use the drop down menu.
Vehicle Country
Use the drop down menu. For further information, please refer below to the table named "Vehicle category"
Vehicle License Plate
As indicated on the vehicle certificate (with or without spaces and or dash)
Min Number of Axles Truck
Our advice is to indicate 2 by default. This data will be used for the set up of the badge.
Vehicle Min Number of Registration Date Axles Trailer (dd/MM/yyyy)
Vehicle Emission
EEV
Use the drop down menu
Gross Vehicle Weight Rating
Field F2 of the vehicle certificate or field F1 if F2 is blank
Authorized Gross Vehicle Weight
Field F3 of the vehicle certificate. If blank, please indicate the same weight than in field "Gross Vehicle Weight Rating"
Our advice is to Exact date on the vehicle Use the drop indicate 3 by default. certificate or leave it down menu This data will be used blank for the set up of the badge.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR ECOTAX + TISPL + ITR
BA BA BA BA BA BA BA BA BA BA BA BA BA
A78-J-751 T64-T-688 A05-T-735 403-J-478 O28-T-352 943-T-374 O28-T-353 E09-T-011 T42-M-638 J81-O-196 A03-K-884 M81-J-168 K67-E-004
2 2 2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3 3 3
Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5 Euro 5
No No No No No No No No No No No Yes No
20100 18000 18000 18000 18000 19000 18000 18000 18000 18000 18000 18000 18000
20100 18000 18000 18000 18000 19000 18000 18000 18000 18000 18000 18000 18000
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62
63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179
180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200
CUSTOMER REGISTRATION FORM FOR SHELL E-BOXES
and French, Spanish, Portugal and Liefkenshoek tunnel e-Toll System
Delivery Address
Mandatory Mandatory Mandatory Optional : have to be filled if the badges have to be delivered to another address
Renting Compan
Optional (Mandatory if Owner of the vehicl
European Vehicle Category
Use the drop down menu. For further information, please refer below to the table named "Vehicle category"
Vehicle Type
Owner of the vehicle
Delivery Contact Title
Use the drop down menu
Delivery Contact LastName
Delivery Contact FirstName
Delivery Contact Street
Delivery Contact Addres Complement
Delivery Contact ZIP
Delivery Contact City
Delivery Contact Country
Use the drop down menu
Renting Company Name
Renting Company Steet
Use the drop down Use the drop menu : down menu : HGV = Truck LGV = Tis VL only C = You are the owner R = Vehicle is rented
N3 N3 N3 N3 N3 N3 N3 N3 N3 N3 N3 N3 N3
HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV HGV
C C C C C C C C C C C C C
Renting Company information
Mandatory
Mandatory if Owner of the vehicle = 'R')
Zip Code Renting Company
City Renting Company
Country Renting Company
Use the drop down menu
VAT ID Renting Company
TISPL InterRoute TISVL ECOTAX + TISPL ECOTAX + TISPL + ITR
AL AD AT BA BE BG BY CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IT LT
LU LV MD MK NL NO PL PT RO RS RU SE SI SK TR UA
TAXE POIDS LOURDS
MANDAT POUR LA DECLARATION DU VEHICULE ET LE PAIEMENT DE LA TAXE Entreprise (raison sociale, adresse) :
Je soussigné (NOM, Prénom) : Agissant en qualité de : 0 dument habilité(e) aux fins des présentes
Donne par la présente, mandat à AXXES SAS située à Tour Oxygène, 10-12 bd Vivier Merle, 69393 LYON CEDEX 03 – France, agissant en qualité de Société Habilité de Télépéage Pour déclarer mon (mes) véhicule(s) à l’enregistrement pour mon compte et me désigner comme redevable enregistré ainsi que pour acquitter la taxe due au titre de la taxe poids lourds en mon nom et pour mon compte. J’atteste avoir fourni à AXXES SAS, des pièces justificatives valides afin de procéder à l’enregistrement de mon (mes) véhicule(s). Ainsi je me porte garant de l’exactitude et de la véracité des dites pièces au regard de la réglementation applicable. Je déclare ne pas être lié contractuellement auprès d’une société tierce pour les services cités ci-dessus, ou, le cas échéant, avoir effectué toutes les opérations de résiliation pour tout autre contrat d’abonnement contracté pour ces services auprès d’une société tierce. Je souhaite recevoir les détails de liquidation et donne, par la présente, mandat à Axxès pour solliciter en mon nom et pour mon compte les détails de liquidation.
Qualité du signataire (ou de la société représentée par le signataire) au regard du (des) véhicule(s)
Liste des véhicules concernés par le présent mandat
Genre National
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Souslocataire
Propriétaire
N° IMMATRICULATION A78-J-751 T64-T-688 A05-T-735 403-J-478 O28-T-352 943-T-374 O28-T-353 E09-T-011 T42-M-638 J81-O-196 A03-K-884 M81-J-168 K67-E-004
ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
X X X X X X X X X X X X X
Fait à , le
07/03/14
Faire précéder la signature de la mention « Bon pour mandat », et apposer le cachet de l’entreprise
Locataire
PAYS D’IMMATRICULATION
Utilisateur
Axxès SAS au capital de 7.500.000,00 Euros Tour oxygène 10-12 Bd Vivier Merle 69393 LYON CEDEX 03 RCS Lyon 482 930 385 N° TVA : FR40482930385
For information only, do not fill in the English version
HEAVY GOOD VEHICLES TAX
MANDATE FOR THE REGISTRATION OF VEHICLES AND PAYMENT OF THE TAX Company name and address: I the undersigned [Last name, First name] : Acting as : duly authorized for the purpose of this mandate
Grants by this letter, mandate to AXXES SAS located Tour Oxygène, 10-12 bd Vivier Merle, 69393 LYON CEDEX 03 – France, acting as SHT (Société Habilité de Télépéage – Approved Electronic Toll Company) To declare my vehicle(s) for registration on my behalf and nominate me as the liable registered person as well as paying the tax applicable to the heavy good vehicles in my name and for my account. I hereby confirm that I have given to AXXES SAS, valid supporting documents in order to proceed registration of my vehicle(s). Thereby, I am answerable for the accuracy and veracity of the documents in light of the applicable regulation. I declare not being contractually bound to a third party supplier for the above described services, or, if required, having conducted all necessary actions for the termination of any other subscription contract taken for the above services to a third party supplier. I wish to receive the detail of tax assessments and give, by this letter, mandate to AXXES SAS, to obtain on my behalf and my account the assessment details.
Description of the signatory (or the company represented by the signatory) in view of the vehicles(s)
List of vehicle affected by the present mandate
National Gender Vehicle Registration Number (VRN)
Rentee
Owner
Done at …………………. on .… / …. / …….
Before the signature, please hand-write « Bon pour mandat », and stamp it with the stamp of your company
Axxès SAS au capital de 7.500.000,00 Euros Tour oxygène 10-12 Bd Vivier Merle 69393 LYON CEDEX 03 RCS Lyon 482 930 385 N° TVA : FR40482930385
User
Vehicle Registration Country
Sub rentee
des présentes
385
385
Object >> Redevable / beholden Redevable category (by default, for Ecomouv, the beholden Is the name on the vehicle registration certificate) Owner or Leased vehicle (for less than 3 months) Tenant of the vehicle (for more than 3 months) or Sub-tenant (for more than 3 months) User
Redevable / beholden
Certificate of incorporation
Mandate
Company
Mandatory
Mandatory
Additional information
AT proof, EORI proof, proof of company registration to the chamber of commerce or proof of association creation
Please find some recommendations to transfer documents :
- You remain responsible of documents until they come to Shell - Always use a encrypted format using WINZIP, before sending it to Shell - Whatever is the sending format (email, USB key, CDROM), send password separately from the winzip fi See below the process :
Sending a ZIP file with encryption
Store the file on a location. Go to the location and right click on the file. Chose the option – Send to -> Compressed (zipped) Folder
A Zip file will be created with the same name as the original file. Open the Zip file by double clicking:
Choose the option Encrypt in the menu icons:
Below screen will appear that allows you to enter a password (2x)
Please ensure the encryption type is set to 256-Bit AES encryption:
Click on OK
The file name will now show it is encrypted as the file has a * – Example.txt*
The Zip file can now be attached to an e-mail and send to the receiver.
Vehicle
Vehicle registration certificate
Certificate of conformity (COC)
CEMT authorization
- If no proof document for axle: number of axle will be considered as "4 and +" by Ecomouv. Mandatory - If no proof document for EURO class: Ecomouv' will use the most unfavourable Euro class.
Out of UE: At least one of this 3 documents must be provided with the Vehicle registration certificate.
ely from the winzip file
e
Manufacturer certificate
Leasing/rental contract
Outsourcing contract
f axle will be considered as "4 and +" ouv. Mandatory
mouv' will use the most unfavourable ss.
Mandatory
Mandatory if name of the Mandatory if name of the ts must be provided with the Vehicle company is not the one company is not the one rtificate. mentioned on Vehicle mentioned on Vehicle registration certificate. registration certificate.
Type of vehicle code
A L M1 M2 M3 N1 N2 N3 I
Other Motor vehicles with two or three-wheel and four motor Vehicles designed and constructed for carrying 9 passengers included the driver Vehicles designed and constructed for carrying more than 9 passengers included the driver and h Vehicles designed and constructed for carrying more than 9 passengers included the driver and h Vehicles designed and constructed for the transport of goods and having a maximum mass not e Vehicles designed and constructed for the transport of goods and having a maximum mass betwe Vehicles designed and constructed for the transport of goods and having a maximum mass excee Not known
Vehicle Country Code
ALBANIA ANDORRA AUSTRIA BÉLARUS BELGIUM BOSNIA BULGARIA CROATIA CYPRUS CZECH REPUBLIC DENMARK ESTONIA FINLAND FRANCE GERMANY GREECE HUNGARY IRELAND ITALY LATVIA LITUANIA LUXEMBURG MACÉDOINE MOLDOVIA NETHERLANDS NORWAY POLAND PORTUGAL ROMANIA RUSSIA SERBIA SLOVAKIA SLOVENIA SPAIN SWEDEN AL AD AT BY BE BA BG HR CY CZ DK EE FI FR DE GR HU IE IT LV LT LU MK MD NL NO PL PT RO RU RS SK SI ES SE
SWITZERLAND TURKEY UKRANIA UNITED KINGDOM
CH TR UA GB
Definition
Other Motor vehicles with two or three-wheel and four motor Vehicles designed and constructed for carrying 9 passengers included the driver Vehicles designed and constructed for carrying more than 9 passengers included the driver and having a maximum mass not e Vehicles designed and constructed for carrying more than 9 passengers included the driver and having a maximum mass exce Vehicles designed and constructed for the transport of goods and having a maximum mass not exceeding 3,5 tonnes. Vehicles designed and constructed for the transport of goods and having a maximum mass between 3,5 and 12 tonnes. Vehicles designed and constructed for the transport of goods and having a maximum mass exceeding 12 tonnes. Not known
Comments
Coach companies are not liable for Ecotax
