| Customer: |
|
| Address: |
|
| NO: |
|
Telephone: |
|
| VAT No.: |
|
FAX: |
|
| Contact person: |
|
| E-mail: |
|
We hereby request
a permit for |
|
| Address: |
|
| Shipping date: |
from: |
to: |
| Relation routing (address of the loading and unloading site, border crossing): |
| from: |
|
| to: |
|
| Type of cargo: |
|
| Length: m |
Width: |
m |
Height: m |
Weight: t |
| Motor vehicle: |
type: |
|
licence plate: |
weight t |
| Trailer/semi-trailer: |
type: |
|
licence plate: |
weight: t |
| Total dimensions and weight of truck with load |
| Length: m |
Width: m |
Height: m |
Weight: t |
| Number of axles/wheels: |
Rear overhang: m |
| Actual weight on the axles: |
|
| Wheelbase: |
|
| Total dimensions and weight of empty truck: |
| Length: m |
Width: m |
Height: m |
Weight: t |
| Number of axles/wheels: |
|
| Actual weight on the axles: |
|
| Wheelbase: |
|
| |
|
|
|
|
|
|
|
|