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["SOLICITUD DE CERTIFICADO LIBRE VENTA"]
["DATOS DEL SOLICITANTE"]
["EMPRESA",{"$nulls":6},"NIF"]
["DIRECCIÓN",{"$nulls":5},"LOCALIDAD"]
["MAIL",{"$nulls":5},"TELÉFONO"]
["DATOS DE LA MUESTRA"]
["Marca comercial",{"$nulls":6},"Añada"]
["Tipo de vino",null,"Tinto",null,"Blanco",null,"Rosado",null,"Otro"]
["Denominación de origen"]
["Numero de laboratorio"]
["CERTIFICADO DE LIBRE VENTA"]
["Sin remitente indirecto"]
["Con remitente indirecto (especificar abajo los remitentes indirectos)"]
["Certificado general (marca de vinos sin especificar)"]
["Copia en papel "]
["REMITENTES INDIRECTOS"]
[]
["Cliente"]
["Población/País"]
["Otros datos"]
[]
["Cliente"]
["Población/País"]
["Otros datos"]
[]
["Cliente"]
["Población/País"]
["Otros datos"]
[]
["Cliente"]
["Población/País"]
["Otros datos"]
[]
["OTROS DATOS"]
[]
[]
[]
["Firma del cliente",{"$nulls":4},"Firma del responsable de recepción"]
[]
[]
[]
[]
[]
["Observaciones (rellenar por el laboratorio)"]