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GE 200D8074P044 User Manual

Page 37

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For Purchases Made In Iowa:

This form must be signed and dated by the buyer and seller prior to the consummation of this sale.

This form should be retained on file by the seller for a minimum of two years.

BUYER:

SELLER:

Name

Name

Address

Address

City

State

Zip

City State

Zip

Signature Date

Signature Date

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