Mail this portion, Please return this portion by facsimile or mail – Makita 5740NB User Manual

Page 14

1. This product was purchased from:

Home Center

Hardware/Lumber Store

Tool Distributor

Industrial Supply

Construction Supply

Other ( )

3. How did you learn about this product:

Magazine

From Dealer

Newspaper

Store Display

Catalog

Radio

Exhibition

From Friend

Previous Usage

Other ( )

2. Use of the product is intended for:

Construction Trade

Industrial Maintenance

Home Maintenance

Hobby

Other ( )

4. Most favored points are:

Repair Service

Durability

Power

Other ( )

Design

Features

Size

Price

Makita Brand

5. Any comments:

MAIL THIS PORTION

Your answers to the following questions are appreciated.

BE SURE TO COMPLETE THE CUSTOMER’S PORTION OF THIS FORM AND RETAIN FOR YOUR RECORDS.

DATE PURCHASED

MODEL NO.

SERIAL NO.

INTL.

LAST NAME / COMPANY NAME

STREET ADRESS

CITY

STATE

AGE:

ZIP CODE

PHONE

AREA
CODE

STATUS

Married

SEX

Single

MONTH

DAY

YEAR

Under 19

20-29

30-39

40-49

50-60

Over 60

Please return this portion by facsimile or mail.

Facsimile No: (714) 522-8133

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