Application for registration in KZR INiG System
………………………., …………….
place date
I. Applicant`s information:
Name of applying company:
Zip code:
Post:
City:
Country:
Address (street, number):
E-mail:
Phone number:
VAT no.
Person entitled to sign the documents
Name, surname
Title
Phone number
Contact person
Name, surname
Title
Phone number e-mail
Address for correspondence (if different from the company`s address provided above )
Zip code:
City:
Country:
Address (street, number):
Issue: 3 Krakow, 2 February 2015 Page 1 of 3
1

Application for registration in KZR INiG System
II. Declared scope of certification (mark as appropriate):

Individual agricultural production and sale (including storage/excluding storage)
1
;

First collection point, storage, incl. group audit of farmers;

First collection point, no storage, but with a group audit of framers;

Waste/residue collection point;

Waste/residue collection and processing/utilization point;

Trading of biomass/processed biomass (with storage/without storage
1
);

Trading of biofuel/fuel with biocomponents (with storage/ without storage
1
);

Oil pressing;

Sugar mill;

Distillery;

Biocomponent production: ethanol/ ETBE/FAME/ other ………………;
 hydrogenation/co-hydrogenation;
 biohydrocarbon production (specify the technology);
 blends with conventional fuel and introduction on the market (specify the biocomponents used;
 biogas production/purification;
 other (please specify)……………………………………………………………….
III. Declared locations operating in accordance with the requirements of the KZR
INiG System (specify addresses):
.................................................................................................................................................
.................................................................................................................................................
IV. I apply for registration in
– KZR INiG System
V. Attachment
1 delete as appropriate
Issue: 3 Krakow, 2 February 2015 Page 2 of 3
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Application for registration in KZR INiG System
1. Proof of registration fee paid to the bank account:
Bank Pekao SA 62 1240 4722 1111 0000 4849 5264 (PLN)
PL 89 1240 2294 1978 0010 4927 6274 PKO PPLPW (EURO)
Note:
The price list provided includes net values.
The registration fee is non-refundable.
VI. Certification body
………………………………………………………………………………………………
VII. I hereby certify the correctness of the information contained in the application.
.............................................................................................
date, signature and stamp of authorized person
Note
Signed application can be sent by post, fax +48 12 6 1 77 522 or a scan may be sent by e-mail: system.kzr@inig.pl
Issue: 3 Krakow, 2 February 2015 Page 3 of 3
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