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Date of purchase: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . / Date d'achat / Fecha de compra /
Data da compra / Data d'acquisto / Kaufdatum / Aankoopdatum / Købsdato / Inköpsdatum /
Kjøpsdato / Ostopäivä / Data zakupu / Data vânzării / Įsigijimo data/ Ostukuupäev / Datum
nakupa / Sorozatszám / Dátum nákupu / Pirkuma datums / Datum Kupovine / Datum kupnje /
Data cumpărării / Datum nákupu / Tarikh pembelian / Tanggal pembelian / Ngày mua hàng/
Satın alma tarihi / Дата прпдажи / Дата прпдажу / Дата на закупуване / Датум на купуваое /
Сатылған мерзімі / Ηµεροµηνία αγοράς/ "))&$ / นที่ ื้ / 購買日期 /購入日 /  /
ªd Ob ¢U¸¥a / ¢U¸¥a «∞Ad«¡
Product reference: . . . . . . . . . . . . . . . . . . . . . . . . . . / Référence du produit / Referencia del
producto / Nome do produto / tipo de prodotto / Typnummer des Gerätes / Artikelnummer van
het apparaat / Referencenummer / Produktreferens / Artikkelnummer / Tuotenumero / referencja
produktu / Model / Gaminio numeris / Toote viitenumber / Tip aparata / Vásárlás kelte / Typ
vyÄrobku / Produkta atsauces numurs / Model proizvoda / Oznaka proizvoda / Cod produs /
Produk rujukan / Referensi produk / Mã sản phẩm/ Ürün kodu / Мпдель / Мпдель / Мпдел
на уреда / Мпделi / Κωδικός προιόνηος / ( / ุ่ นผล ตภ ณฑ / 產品模型 / 製品レ /
#/
±d§l JULq L∫Bu‰ / ±d§l «∞LÔM∑ÓZ «∞JULq
Distributor stamp . . . . . . . . . . . . . . . . . . . . . . . Cachet distributeur /Sello del distribuidor /
Carimbo do revendedor / Timbro del negozzio / Händlerstempel / Stempel van de dealer /
Forhandler stempel / Återförsäljarens stämpel / Forhandler stempel / Jälleenmyyjän leima /
pieczęć sprzedawcy / Ştampila vânzătorului / Antspaudas / Tempel / Žig trgovine / Eladó neve,
címe/ Razítko predajcu / Zīmogs / Pečat maloprodaje/ Pečat prodavca / Pečat prodajnog
mjesta / Ştampila vânzătorului/ Razítko prodejce/ Cap peruncit / Cap dari Toko Penjual / Cửa
ng bán đóng du/ Sacı Firmanın Kaşesi / Печать прпдавца / Печатка прпдавця / Печат на
търгпвския пбект / Печат на прпдавницата / СатушыныÎ мÒрі / Σθραγίδα καηαζηήµαηος /
"))(&!'& / ตราประท บของห ง/ร านที่ / / / (&' !/
≠¸ug LN¸ ª¸bˆ / ª∑ °Uzl «∞∑§ezW
Retailer name & address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /
Nom et adresse du vendeur / Nombre y dirección del minorista / Nome e endereço do revendedor /
Nome e indirizzo delnegozzio / Name und Anschrift des Händlers / Naam en adres van de dealer /
Forhandler navn & adresse / Återrsäljarens namn och adress / Forhandler navn og adresse /
Jälleenmyyjän nimi ja osoite / nazwa i adres sprzedawcy / Numele şi adresa vânzătorului /
Parduotuvės pavadinimas ir adresas / Müüja kauplus ja aadress / Naziv in naslov trgovine /
Tipusszám / Názov a adresa predajcu / Veikala nosaukums un adrese / Naziv i adresa maloprodaje /
Naziv i adresa prodavca / Naziv i adresa prodajnog mjesta / Nume şi adresă vântor / Název a
adresa prodejce / Nama dan alamat peruncit / Nama Toko Penjual dan alamat / n địa chỉ
cửa hàng bán/ Satıcı firmanın adı ve adresi / Название и адрес прпдавца / Назва і адреса
прпдавця / Търгпвки пбект / Назив и адреса на прпдавницата / СатушыныÎ аты жəне
мекен-жайы / Επωνυµία και διεύθσνζη καηαζηήµαηος / "))(& )')'( )#' /
อและที่ อยู่ ของห าง/ านี่ ื้ / 零售商的店名和地址/売店の名前、住所/(&' "$% (/
≤UÂ Ë ¬œ¸” îdœÁ ≠dË‘ / «ßr Ë´Mu«Ê °Uzl «∞∑πezW
INICIO-NC00023316_INICIO-NC00023316 27/07/11 12:32 Page13
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