diff --git a/app/assets/css/main.css b/app/assets/css/main.css
index 728c152..c9eb9ab 100644
--- a/app/assets/css/main.css
+++ b/app/assets/css/main.css
@@ -39,6 +39,10 @@
     }
 }
 
+hr {
+    width:100%; border: 1px solid black;
+}
+
 #form-iban {
     display: none;
 }
@@ -53,7 +57,6 @@
     font-weight: bold;
 }
 
-
 #html > div {
     margin-bottom: 1.5rem;
 }
@@ -76,4 +79,7 @@
     .no-print{
         display: none;
     }
+    hr {
+        display: block;
+    }
 }
\ No newline at end of file
diff --git a/app/assets/img/210210_angestöpselt_logo_final_web.jpg b/app/assets/img/angestöpselt_logo_web.jpg
similarity index 100%
rename from app/assets/img/210210_angestöpselt_logo_final_web.jpg
rename to app/assets/img/angestöpselt_logo_web.jpg
diff --git a/app/assets/js/main.js b/app/assets/js/main.js
index eef68d4..33301a9 100644
--- a/app/assets/js/main.js
+++ b/app/assets/js/main.js
@@ -77,6 +77,7 @@ function storeFormData() {
     console.log("here");
     var name = $('#name').val();
     var adresse = $('#adresse').val();
+    var citydate = $('#citydate').val();
     var leistung = {};
     var betrag = {};
     $('.form-leistung').each(function(index, item) {
@@ -89,6 +90,7 @@ function storeFormData() {
 
     localStorage.setItem('name', name);
     localStorage.setItem('adresse', adresse);
+    localStorage.setItem('citydate', citydate);
 
     var gesamt = $('#gesamt').val();
     localStorage.setItem('gesamt', gesamt);
@@ -113,10 +115,12 @@ function getFormData() {
     var verzicht = localStorage.getItem('verzicht');
     var auszahlung = localStorage.getItem('auszahlung');
     var iban = localStorage.getItem('iban');
+    var citydate = localStorage.getItem('citydate');
     var gesamt = localStorage.getItem('gesamt');
 
     $('#name').text(name);
     $('#adresse').text(adresse);
+    $('#citydate').text(citydate);
 
     var leistung = JSON.parse(localStorage.getItem('leistung'));
     var betrag = JSON.parse(localStorage.getItem('betrag'));
diff --git a/app/index.html b/app/index.html
index 485dc98..faf0b3a 100644
--- a/app/index.html
+++ b/app/index.html
@@ -20,7 +20,7 @@
   <div class="container">
     <header class="d-flex flex-wrap justify-content-center py-3 mb-4 border-bottom">
       <a href="/" class="d-flex align-items-center mb-4 mb-md-0 ms-md-auto text-dark text-decoration-none">
-        <img src="assets/img/210210_angestöpselt_logo_final_web.jpg" alt="Angestöpselt" title="Angestöpselt" width="400" height="62.5">
+        <img src="assets/img/angestöpselt_logo_web.jpg" alt="Angestöpselt" title="Angestöpselt" width="400" height="62.5">
       </a>
     </header>
 
@@ -75,7 +75,11 @@
                 <label for="iban" class="form-label">IBAN</label>
                 <input id="iban" name="iban" type="text" class="form-control" />
               </div>
-
+              <br>
+              <div class="mb-4">
+                <label for="citydate" class="form-label">Ort, Datum *</label>
+                <input id="citydate" name="citydate" type="text" class="form-control" required="required" />
+              </div>
               <div class="mb-4">
                 <div class="btn btn-primary btn-continue">Weiter</div>
               </div>
diff --git a/app/print.html b/app/print.html
index b88e292..ae51186 100644
--- a/app/print.html
+++ b/app/print.html
@@ -20,7 +20,7 @@
     <div class="container">
         <header class="d-flex flex-wrap justify-content-center py-3 mb-4 border-bottom">
             <a href="/" class="d-flex align-items-center mb-4 mb-md-0 ms-md-auto text-dark text-decoration-none">
-                <img src="assets/img/210210_angestöpselt_logo_final_web.jpg" alt="Angestöpselt" title="Angestöpselt" width="400" height="62.5">
+                <img src="assets/img/angestöpselt_logo_web.jpg" alt="Angestöpselt" title="Angestöpselt" width="400" height="62.5">
             </a>
         </header>
 
@@ -65,7 +65,30 @@
                                 <div id="auszahlung"></div>
                                 <div id="iban"></div>
                             </div>
+                            <div>
+                                <span>Ort, Datum:</span>
+                                <div id="citydate"></div>
+                            </div>
+                            </div>
+                        <div class="block_1"></div> <hr />
+                        <div>
+                            <span>Genehmigt und erledigt durch:</span>
                         </div>
+                        <br><br><br><br><br><br>
+                        
+                        <div class="row">
+                            <div class="col col-3">
+                                <hr />
+                                <div>Datum</div>
+                            </div>
+                            <div class="col col-5">
+                                <hr />
+                                <div>Unterschrift / Stempel</div>
+                            </div>
+                        </div>
+                        <br>
+                        </div>
+                        <br>
                         <button class="btn btn-primary no-print" onclick="window.print();">Drucken</button>
                     </div>
                 </div>