Samuel Hardy,

an individual, born on 1982-01-10 at {Birth.Adr.City}, {Birth.Adr.State}, {Birth.Adr.Nation},
a citizen of {Citizen.nationality},
whose profession is {Work.profession},
residing at 111 Mission Street, San Francisco, CA 94103, United States of America,
herein referred to as "{Handle}",

Samuel Hardy,

Né le 1982-01-10 à {Birth.Adr.City}, {Birth.Adr.State}, {Birth.Adr.Nation},
de nationalité {Citizen.nationality},
Exerçant la profession de {Work.profession},
Demeurant 111 Mission Street, 94103 San Francisco , United States of America,
ci-après dénommée la « {Handle} »,

Samuel Hardy

urodzonym dnia 1982-01-10 w {Birth.Adr.City}, {Birth.Adr.State}, {Birth.Adr.Nation},
posiadającym obywatelstwo {Citizen.nationality},
z wykształcenia {Work.profession},
zamieszkałym pod adresem 111 Mission Street, San Francisco, CA 94103, United States of America
zwanym dalej «{Handle}»,

Samuel Hardy

("{Handle}")

{xSignature}

Date: {Sign.YMD}
Signed at: San Francisco, California, United States of America

Samuel Hardy

( « {Handle} » ),

{xSignature}

le : {Sign.YMD}
à : San Francisco, California, United States of America

Samuel Hardy

("{Handle}")

{xSignature}

Dnia: {Sign.YMD}
Podpisana w: San Francisco, California, United States of America