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Text File  |  1978-06-02  |  4KB  |  61 lines
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  23. -                                                                     
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  26. Datum                                                                 
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  29. Schadensmeldung                                                       
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  32. Schadensfall   .......................................................
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  35. Ort :          .......................................................
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  37. Geschädigter:  .......................................................
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  39. Schadenshöhe:  .......................................................
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  42. Vorgang:                                                              
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  44.  (Hier schildern Sie bitte , wie es zu dem Schadensfall gekommen ist) 
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  47. Zeugen :       .......................................................
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  52. Unterschrift                                                          
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