Derby cycle Pedelec - Page 2

My bicycle
Brand:
Model:
Colour:
Bicycle weight:
Serial number (S/N)
1
:
Frame number
2
:
Purchase date:
My dealer
Company:
Contact person:
Street:
Postal code, town:
Telephone:
E-mail:
My contact information
First owner
Customer no.:
Family name:
First name:
Street:
Postal code, town:
Telephone:
E-mail:
Purchase date:
Date, signature
Second owner
Customer no.:
Family name:
First name:
Street:
Postal code, town:
Telephone:
E-mail:
Purchase date:
Date, signature
1 See  10.3 Bicycle (motorless)/S-Pedelec: serial and product number Page EN-16 and  10.4 Pedelec: type plate Page EN-16
2 See  10.1 Frame number Page EN-16