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Forhandler/værksted - virksomhedsnr. | Kunde | |
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Køretøjs-id-nr. | Reparationsordrenr. | |
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Kontrolleret af: Navn | Dato | |
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Registreringsnummer Første indregistrering Type | Motornr. | Speedometerstand: km/miles |
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Afregningsnummer: | 5891249 |
Kontaktperson | ____________________________________________________________ |
Telefonnummer: | ____________________________________________________________ |
Fax: | ____________________________________________________________ |
pr. e-mail til: | |