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Text File  |  1995-02-26  |  2KB  |  25 lines
  1. ┌─────────────────────────────────────────────────────────────────────────────┐
  2. │  Bankverbindung: Ralf Stark              │     Lizenzantrag / TRIANGOLO     │
  3. │                  Knt.Nr. : 0939555500    │                                  │ 
  4. │                  Berliner Bank           │__________________________________│
  5. │                  BLZ     : 100 200 00    │Name                              │
  6. │                  Betrag  : DM 6,-        │                                  │
  7. │                        (incl. Rückporto) │__________________________________│
  8. │                  => Einz.beleg liegt bei │Straße                            │
  9. │                                          │                                  │
  10. │                                          │_______  _________________________│
  11. │         ^*^                              │PLZ      Ort                      │
  12. │                                          │                                  │
  13. │    An:  Ralf Stark                       │         Alter(freiwillig): ______│
  14. │                                          │                                  │
  15. │         Nansenstraße 32                  │                                  │
  16. │                                          │         ____________, den _______│
  17. │         12047 Berlin                     │                                  │
  18. │                                          │                                  │
  19. │                                          │         _________________________│
  20. │                                          │         Unterschrift             │
  21. │                                          │                                  │
  22. └─────────────────────────────────────────────────────────────────────────────┘
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