Name *

Company

Address

City

e-mail *

Phone

Cell.

(*) Mandatory

(**) In full observance of art. 13 of Italian Legislative Decree 196/03 (Personal Data Protection Code), Vapsint declares that the details given will be used exclusively for statistical purposes and/or in any case within the company. I hereby authorize treatment of my personal details in observance of the contents of art. 13 of Italian Legislative Decree 196/03 on the subject of Personal Data Protection.

∅ Body (mm)

∅ Rod (mm)

Lenght hole-hole LTA (mm)

Stroke (mm)

Thrust (kg)

End rod fitting ATS

End body fitting ATC

Other code or note