Makita MAC5200 Owner's Manual page 21

MAIL THIS PORTION
Your answers to the following questions are appreciated.
1)
This product was purchased from:
Home Center
Hardware/Lumber Store
Tool Distributor
Industrial Supply
Construction Supply
Other
2)
Use of this product is intended for:
Construction Trade
Industrial Maintenance
Home Maintenance
Hobby
Other
5)
Any comments:
DATE PURCHASED
MONTH DAY
INTL. LAST NAME / COMPANY NAME
ADDRESS:
CITY:
ZIP / POSTAL CODE:
AREA CODE:
AGE: Under 19
BE SURE TO COMPLETE THE CUSTOMER'S PORTION OF THIS FORM AND RETAIN FOR YOUR RECORDS
Please return this portion by facsimile or mail ... Facsimile Number (714) 522-8133
MODEL NO.
YEAR
SERIAL NO.
STATE / PROVINCE:
TELEPHONE:
20 - 29 30 - 39
3)
How did you learn about this product:
Magazine
Dealer
Newspaper
Store Display
Catalogue
Other
4)
Most favored points are:
Design
Features
Size
Price
Other
STATUS
Married Single
COUNTRY:
-
40 - 49 50 - 59
Radio
Exhibition
From Friend
Previous Usage
Repair Service
Durability
Power
Makita Brand
SEX
Male Female
Over 60