Labels:dialog box | window OCR: FIRST NAME Jan LAST NAME Novak COMPANY Novak syn ADDRESS1 ADDRESS 2 CITY Bmo STATE PROYINCE ZIP/POSTAL CODE 60200 COUNTRY Other Other" specify country: Czech renuhlic TELEPHONE 42051 23456 FAX 205 123457 E-MAIL info@ iannovak.cz Submit Clear Form Vovak Jablonova CIJY Brno county republic 2051 2345