Branch/Agency - Firm no. Customer
Vehicle ident no. Repair order no.
Tester: Name Date
License plate no. Original registration date Model Engine no. Odometer reading: km/miles
Print out order, fill out and send prepaid, together with copy of monetary transfer and wood trim part, to:
Messrs. HIB-Logistikzentrum
Wolf-Hirth-Straße 33
71034 Böblingen-Hulb (Germany)
Order Date
Messrs. HIB-Logistikzentrum
Wolf-Hirth-Straße 33
71034 Böblingen-Hulb (Germany)
Return address
Company
P68.20-2273-07
Center console, model 215
Molding above instrument panel, model 220 RHS
Molding above instrument panel, model 220 LHS
Indicate desired switch opening (check)
Damage before shipment:
Total of: Euro transferred on: