Retailer name and address: . . . . . . . . . . . . . . . . . . . . . . . . . . . / Nom et adresse du vendeur /Nombre y dirección del minorista /Nome e endereço do revendedor /Nome e indirizzo del negozzio /Name
und Anschrift des Händlers /Naam en adres van de dealer /Forhandler navn & adresse /Återförsäljarens 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 vânzător /Název a adresa prodejce /Nama dan alamat peruncit /Nama Toko Penjual dan
alamat /Tên và địa chỉ cửa hàng bán/Satıcı firmanın adı ve adresi /Название и адрес продавца / Назва і адреса продавця / Търговки обект / Назив и адреса на продавницата / Сатушының аты және
мекен-жайы /Επωνυμία και διεύθυνση καταστήματος/ Վաճառողի անվանումը և հասցեն / //零售商的店名和地址/販売店の名前、住所/소매점이름과주소/ ﻭ ﺔﺋﺰﺠﺘﻟﺍ ﻊﺋﺎﺑ ﻢﺳﺍ
ﺵﻭﺮﻓ ﻩﺩﺮﺧ ﺱﺭﺩ ﻡﺎﻧ / ﻪﻧﺍﻮﻨﻋ
Distributor stamp. . . . . . . . . . . . . . . . . . . . . . . . . . . . ./ Cachet distributeur /Sello del distribuidor /Carimbo do revendedor /Timbro del negozzio/Händlerstempel/Stempel van de dealer /Forhandler
pembelian /Tanggal pembelian /Ngày mua hàng /Satın alma tarihi /Дата продажи / Дата на закупуване / Датум на купување / Сатылған мерзімі /Ημερομηνία αγοράς /Վաճառքի օրը /
購買日期/購入日/구입일자/ﻱﺮﺧ ﺦﻳﺭﺎﺗ/ءﺍﺮﺸﻟﺍ ﺦﻳﺭﺎﺗr
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 výrobku /Produkta
atsauces numurs /Model proizvoda /Oznaka proizvoda /Cod produs /Produk rujukan /Referensi produk /Mã sản phẩm/Ürün kodu /Модель / Модель / Модел на уреда / Моделi / Κωδικός προιόντος
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