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Purchaser's Name: ____________________________________________
Address: ____________________________________________________
___________________________________________________________
Country: ____________________________________________________
Phone: _____________________________________________________
Date of Purchase (dd/mm/yy):
Product Type (on type label):
Product Code (on type label):
Product Serial No (on type label):
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Place of Purchase: ____________________________________________
Store Name: _________________________________________________
Store Address: _______________________________________________
___________________________________________________________
© Nokia Corporation 2004. All rights reserved.
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