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Record of Purchase Form


[Your company name]
[Your company address:
Street
City, State, Zip]

Date:
[Name]
[Address:
Street
City, State, Zip]

Dear _________,

We would appreciate your returning this record of purchase so that we will be able to assist you with any questions or problems in the use of our product. In our desire to constantly improve our products and service to you, we request that you answer as many questions as possible.

Thank you.


____________________________________________________________


RECORD OF PURCHASE

Name________________________Date Purchased__________________
Address_____________________________________________________
City_________________State__________________Zip_____________


1.Purchaser _____Man_______Woman________Teenager________Youth
2.Age of users ________
3.Name of store where purchased _____________________________
4.Purchased for ________ Gift _________ Personal Use
5.Price paid $_________
6.Would you recommend this product to others?_______________
7.Comments:_________________________________________________
____________________________________________________________


Please be aware that these sample letters and forms may have legal and financial implications. Please consult with your own legal advisor if you have any questions or concerns regarding the use of any of these letters and forms.