Type Z EIC code application for the connection point

* Required

Select the appropriate option* for the assignment of EIC code type Z for data modification within the EIC code type Z for the deactivation of the EIC code type Z (Fill in only EIC code type Z and Display name in the Connection point data)	Date of application*
Applying Party’s EIC code (type X)*

Connection point data
No.	Point name*	Display name (proposition)*	Point type*	TSO 1 name*	EIC TSO 1 identification*	TSO 2 name	EIC TSO 2 identification	EIC code for the point (type Z)*	Is the EIC code necessary to fulfil the publication/ reporting obligations pursuant to EU legislation (eg. REMIT)?*
Max 70 characters. Acceptable characters: alphanumeric characters, Polish diacritics, spaces, punctuation marks (comma, period), apostrophe, plus and minus signs	Max 16 characters. Unacceptable characters: spaces, periods. Acceptable characters: capital Latin alphabet, numbers, plus and minus signs, underscores	Select the appropriate option	Fill in only in case of data modification or code deactivation
1	- Select -	- Select -
2	- Select -	- Select -
3	- Select -	- Select -
4	- Select -	- Select -
5	- Select -	- Select -
No.	Point name*	Display name (proposition)*	Point type*	TSO 1 name*	EIC TSO 1 identification*	TSO 2 name	EIC TSO 2 identification	EIC code for the point (type Z)*	Is EIC code necessary for publication/ reporting according with EU legislation (eg REMIT)?*
6	- Select -
7	- Select -
8	- Select -
9	- Select -
10	- Select -

Contact person*
E-mail*	Telephone*
Person authorised to represent Party*
……………………………………………...…..	……………………………………………...…..
Personal stamp, signature	Personal stamp, signature

The applicant accepts The Energy Identification Coding Scheme (EIC) Reference Manual and respects the provisions set forth in this manual.

Gas market participant who has applied for receiving or received an EIC code is obliged to notify LIO about any changes made to the data in the application immediately through applying for data modification or code deactivation.

I read, understood and I accept the terms of GAZ-SYSTEM privacy policy and I consent, in particular, on GAZ-SYSTEM processing my personal data (abovementioned) for an EIC Code, and for sharing such personal data with the Central Issuing Office (ENTSO-E) for the same purpose.