Name and code of the products Purchased from (firm, shop address, tel.) Invoice (fiscal bond) No Date of sale from the date of purchase Stamp and signature of the seller Date Name of the product Reasons for the claim Signature and stamp of the seller Customer signature Date Name of the product Reasons for the claim Signature and stamp of the seller Customer signature Date Name of the product Reasons for the claim Roca Bulgaria AD Signature and stamp of the seller Customer signature