Form - Power of Attorney D (R)

Inozemni državljani mogu postati članovi HUZIP-a i povjeriti HUZIP-u ostvarivanje svojih prava.

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 and address) / SWIFT for banks abroad: *
Giro account IBAN: *
Sex:
Date of birth: *
Place: *
Country: *
Personal identification number assigned by the Croatian Tax Administration:
IPN (if assigned):
Country of residence: *
Nationality: *
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