MIP-0025-E

Repayment of fee

Repayment of fee

Please fill in the form and send it to kemi@kemi.se.

It may take up to 30 days from submission of the form until you receive the refund.

Case information

Swedish Chemicals Agency case no.	Amount to be refunded in SEK
Product name (if applicable)	Invoice reference no. (on the invoice paid)

Your contact details

Company name	VAT no.
Postal address	Contact person (name/e-mail/tel.)
Postal code and town	Country

Bank details

Bank	Account number
Bank address	SWIFT code
IBAN no.
Repayment reference (contact person/other)	ABA/FW no. (US only)

För Kemikalieinspektionen

Konto	Kostnadsställe	Verksamhet	Finansiering
Utbetalt datum	Ekonomifunktionens notering