Customer address:
Last name, first name:
Profession:
Street, number:
Postal code, town:
Country:
Vehicle data:
Model:
Type:
Key no.:
Vehicle chassis number:
Serial no.:
Date of first registration/date of transfer:
Expiry date of guarantee period:
Dealer data:
Dealer no.:
Stamp and signature of LMC dealer
45
LMC guarantee
document
