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Text File  |  1993-12-14  |  3KB  |  1 lines

  1.                             ║                    ┌────────┐                             ║                    │        │                             ║                    │        │                             ║                    │        │                             ║                    └────────┘                             ║                                                           ║                                                           ║                                  ╔═══════════╗            ║                                  ║POST-      ║            ║  P O S T A M T                   ║LAGERUNGS- ║            ║                                  ║ANTRAG     ║            ║  Nachsendestelle                 ╚═══════════╝            ║                                                           ║                                                           ║                                                           ║ »47110 «»Musterstadt        «                            ║   ......  ...................                             ║    (PLZ)   (Zustellpostamt)                                                                                                                                                                                                                                                                                                                                                                                                                                        LAGERUNG Antrag des Empfängers            Bitte ankreuzen !┌─────────────────────────────────────                      │Antragsteller (Namen und Vornamen)                          »Klaus Mustermann                  «|» « BRIEFSENDUNGEN    ─────────────────────────────────────                                                             » « PÄCKCHEN         ┌─────────────────────────────────────                      │Anschrift (Straße, Postfach, Ort)     » « ZEITUNGEN         »Musterweg 47                       «                       »47110 Musterstadt                  «    (ohne Nachnahme)                                          ╔════════════╗                                              ║ POST-      ║                                              ║ LAGERUNGS- ║                                              ║ ANTRAG     ║                                              ╚════════════╝     ┌─────────────┌────────────┌──────────                      │Lagerung     │vom:        │bis:         ┌────────────────── |»          « »          «»          «  │Unterschrift