Appendix K - NMEDA Monthly Label Use Form Summary

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APPENDIX K - NMEDA Monthly Label Use Form Summary

 

Reporting Year/Month: ______/____

 

 

Dealer:

 Columbus Mobility Specialists, Inc.

Address:

 6330 Proprietors Road, Suite C

City, State, Zip Code:

 Worthington, Ohio 43085

 

 

Labels On-Hand at the Beginning of the Month:

From Beginning Label N-

_______________________________________________

To Ending Label N-

_______________________________________________

 

 

Labels On-Hand at the End of the Month:

From Beginning Label N-

_______________________________________________

To Ending Label N-

_______________________________________________

 

 

This cover form must be completed at the end of each month and returned to RADCO.  All labels used during the month and those on-hand must be reported and accounted for.  Please mail this form to :  RADCO, 3220 E. 59th Street, Long Beach, CA 90805.

 

Page Revision Date
12/23/2002

NMEDA QAP
Manual Page 25