1-800-345-DELTA (3358)
www.deltafaucet.com
19
For purchases made in Iowa:
This form must be signed and dated by the buyer and seller prior to consummation of this sale.
This form should be retained on file by the seller for a minimum of two years.
BUYER:
Name
Address
City State Zip
Signature Date
SELLER:
Name
Address
City State Zip
Signature Date
PURCHASES MADE IN IOWA:
