Family name:

Name:

Town:

Country:

Albania Algeria American Samoa Andorra Angola Anguilla Antigua/Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Chad Chile China Colombia Congo Brazzaville Congo Democratic Rep. of Cook Islands Costa Rica Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Palestine Autonomous Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saipan Samoa Saudi Arabia Senegal Serbia-Montenegro Seychelles Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka St. Kitts/Nevis St. Lucia St. Vincent Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Tonga Trinidad/Tobago Tunisia Turkey Turkmenistan Turks & Caicos Islands U.S. Virgin Islands U.S.A. - Alabama U.S.A. - Alaska U.S.A. - Arizona U.S.A. - Arkansas U.S.A. - California U.S.A. - Colorado U.S.A. - Connecticut U.S.A. - Delaware U.S.A. - District Of Columbia U.S.A. - Florida U.S.A. - Georgia U.S.A. - Hawaii U.S.A. - Idaho U.S.A. - Illinois U.S.A. - Indiana U.S.A. - Iowa U.S.A. - Kansas U.S.A. - Kentucky U.S.A. - Louisiana U.S.A. - Maine U.S.A. - Maryland U.S.A. - Massachusetts U.S.A. - Michigan U.S.A. - Minnesota U.S.A. - Mississippi U.S.A. - Missouri U.S.A. - Montana U.S.A. - Nebraska U.S.A. - Nevada U.S.A. - New Hampshire U.S.A. - New Jersey U.S.A. - New Mexico U.S.A. - New York U.S.A. - North Carolina U.S.A. - North Dakota U.S.A. - Ohio U.S.A. - Oklahoma U.S.A. - Oregon U.S.A. - Pennsylvania U.S.A. - Rhode Island U.S.A. - South Carolina U.S.A. - South Dakota U.S.A. - Tennessee U.S.A. - Texas U.S.A. - Utah U.S.A. - Vermont U.S.A. - Virginia U.S.A. - Washington U.S.A. - West Virginia U.S.A. - Wisconsin U.S.A. - Wyoming Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis & Futuna Yemen Zambia Zimbabwe *

E-mail:

Model:

TR2 TR3 TR3A TR3B *

Year:

1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 *

Commisssion #:

*

Color body:

       * Obligatory data

         (as email's attachment)