IFB 30SC2 - Page 15

CUSTOMER COPY
Mr./Mrs./Ms.
Address.
Telephone No.:
Model Name:
Serial No.:
Date of Purchase:
Cash Memo No.:
Dealer Name and:
Address Stamp:
Mr./Mrs./Ms
Address:
Service Station Copy
Middle Name
Pin Code:
Telephone No.: (R)_(0)_
E-mail Address:
Model Name:
Serial No.:
Date of Purchase:
Cash Memo No.:
Products Owned by the customer:(Please tick in the appropriate box.)
I I Washing Machine IZZ1 Refrigerator [ZZ1 Color TV [ZZI 100% Clothes Dryer I I Dishwasher
I I Music System IZZbven Toaster Grill I 1 2 Wheeler I I Car I I Air Conditioner