Claim Taxi Price


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    Your Name and Surname (required)

    Your E-mail (required)

    Your phone number (required)

    Date of the taxi service (required)

    Name or ID of the Taxi

    Start address (required)

    Destination address (required)

    I have and can give you taxi receipt: (required)
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    Attach photo/scan of the receipt
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    Description of the taxi ride:

    In ottemperanza al D.L. n. 196 del 30/06/2003 (Tutela della privacy) l’invio del presente modulo autorizza la Cooperativa radiotaxi Padova S.c.a r.l. al trattamento dei dati personali inseriti esclusivamente per consentire un riscontro alla presente richiesta.