Form No. 10
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(company name) (place) (date)
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(address)
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(telephone, fax) KDPW_CCP S.A.
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(NIP)
DECLARATION
authorising the use of electronic invoices
We hereby represent that we authorise KDPW_CCP S.A. to send us from the e-mail address , in electronic form, in PDF format, all invoices, correction invoices and duplicate invoices issued to us, at the following
e-mail address:
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(please print)
Furthermore, we represent that:
1) this authorisation does not preclude KDPW_CCP S.A.’s right to send us invoices, correction invoices and duplicate invoices in traditional (paper) form;
2) we grant this authorisation for an undetermined period; if we cancel this authorisation, such cancellation is effective as of the first day of the calendar month following the month of its proper delivery to the seat of KDPW_CCP S.A. but not later than 30 days from its delivery (proper delivery is understood to mean delivery in written form to the seat of KDPW_CCP S.A. of the declaration of cancellation of the authorisation, signed by duly authorised representatives of the entity issuing the declaration);
3) this authorisation is granted to the extent of legal relationships already in existence, as well as legal relationships to be established in future between us and KDPW_CCP S.A.; consequently, we authorise the modification of obligations arising thereunder to the extent of this authorisation;
4) this authorisation includes the authorisation of e-mail transmission of any data indicated in an invoice, correction invoice and duplicate invoice relating to provided services, including those protected by law;
5) we undertake to notify KDPW_CCP S.A. immediately of any change of data affecting effective and proper transmission to us by KDPW_CCP S.A., in electronic form, of any invoices, correction invoices and duplicate invoices issued to us, in particular any change of the aforementioned e-mail address; point 2 above applies accordingly to such such extent;
6) in any case where an invoice for a service or a correction invoice or duplicate invoice is not received, we undertake to notify KDPW_CCP S.A. immediately thereof; furthermore, we represent that we bear all consequences of any failure to give such notification;
7) in view of the obligation under the VAT law to confirm the receipt of correction invoices reducing the amount of the input tax, we also undertake to confirm immediately the receipt, in electronic form, of correction invoices by providing KDPW_CCP S.A. at each time with a feedback message containing a firm and unequivocal confirmation of receipt of the correction invoice.
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(signatures and personal stamps, company seal)