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Chapter 276-3 BILL OF SALE

Rule 276-3-.01 Bill of Sale

At the time of delivery, the dealer or dispenser shall provide to the person supplied with a hearing aid a bill of sale. The bill of sale will contain, as a minimum, the following:

(a) Dealer and Dispenser information:
1. Dealer name and license number.
2. Dispenser name and license or permit number.
3. Street address and office hours of dealer location.
(b) Hearing Aid information:
1. Make, mode l, and serial number.
2. Description of Condition (new, reconditioned, used).
3. Statement whether there is a guarantee or warranty and the terms thereof.
(c) Price, Refund and Credit information:
1. Sale price including any discount(s), trade-in allowance(s) and sales tax(es).
2. On the written receipt or bill of sale, in all capital letters shall be printed, or rubber stamped, in black or blue ink, at least twelve (12) point type size, one of the following paragraphs:

THE SALE OF THIS HEARING AID IS FINAL. I UNDERSTAND I AM NOT ENTITLED TO A REFUND OR CREDIT.

(or)

I READ, UNDERSTAND AND HAVE SIGNED OR INITIALED A COPY OF THE REFUND AND RETURN POLICY. THE POLICY STATES IF, AND UP UNTIL WHAT DATE, I CAN RETURN THE HEARING AID FOR A FULL REFUND, A PARTIAL REFUND OF WHAT PERCENTAGE, OR A FULL OR PARTIAL CREDIT. THE POLICY ALSO IDENTIFIES WHAT FEES, IF ANY, FOR SERVICES WILL BE REFUNDED OR CREDITED WHEN THE HEARING AID IS RETURNED FOR REFUND OR CREDIT.

3. The dealer will provide a copy of the refund policy to the person purchasing the hearing aid. The copy of the refund policy should be signed with a separate signature or initials of the customer and the copy that is signed or initialed by the customer will be maintained on file by the dealer with the bill of sale, for at least six (6) years after the delivery of the hearing aid.
(d) Test information:
1. Serial number of audiometer used for examination.
2. Date of most recent calibration of audiometer in (a) above.
(e) User and purchaser information:
1. Name and street address of hearing aid user.
2. Name and address of purchaser. If the same as user, indicate on bill of sale.
3. Date of delivery to user or purchaser.
4. Signature of purchaser to acknowledge receipt of the hearing aid and copy of the bill of sale.