Makita 6176D - Manual (Page 14)

14
Your answers to the following questions are appreciated.
Date Purchased Model No.
Serial No.
Initial Last Name
Street Address
City Province
AGE:
Male Female Married Single
Month Day Year 20
Under 19 20-29 30-39 40-49 Over 50
Paste Paste Paste Paste Paste Paste Paste Paste
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1. This product was purchased from?
Industrial Supply
Other ( ) Tool Distributor
Hardware/lumber Store
2. Use of the product is intended for?
5. Any comments?
Home maintenance
Other ( ) Industrial maintenance
Construction trade
3. How did you first learn of Makita Power Tools?
Catalog
Other ( ) From dealer
Magazine/Newspaper
Store display
4. Most favored points are?
Makita Brand
Power Features
Design
Other ( ) Size
Price
Occupation:
Dealer's Name & Address:
Postal Code
Certificate of Warranty
Mail to Makita