Form - Power of Attorney A

Umjetnici izvođači – državljani Republike Hrvatske ispunjavaju Osnovnu punomoć kojom povjeravaju HUZIP-u ostvarivanje svojih prava za cijeli svijet.

Please enter the data into the provided fields. Fields marked with an asterisk are mandatory.

Name: *
Surname: *
Stage name:
Maiden name:
Address: *
City: *
ZIP code: *
Country: *
Bank name: *
Giro account IBAN: *
Member of the second pillar pension insurance (opcionalno):
Liable to VAT (opcionalno):
I keep business records (books) (opcionalno):
Society membership:
Sex: *
Date of birth: *
Place: *
Country: *
Master citizen number or no. of identity card: *
Personal identification number: *
Country of residence: *
Telephone:
Fax:
GSM:
E-mail:
Performing capacity: *
List all instruments used on the recordings:
Member of orchestra/group (state the name and date of joining):
Previous engagements in orchestra/group:
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The completed form should be downloaded and then printed, signed in own hand in where necessary and send by regular post to the address:

HUZIP
Ivana Broza 8A
10000 Zagreb