[Company / sole trader name]
[Street and number]
[Postal code and city]
[Country]
E-Mail: mathias@dataandhorses.com
[Phone, optional]
[Name(s) of the person(s) authorised to represent]
[VAT ID if applicable, per § 27a UStG]
[Name and address of the person responsible for content, per § 18 Abs. 2 MStV]