Makita DA6300 Instruction Manual page 14

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
2. Use of the product is intended for:
Construction Trade
Industrial Maintenance
Home Maintenance
Hobby
Other ( )
5. Any comments:
DATE PURCHASED
MONTH DAY
INTL. LAST NAME / COMPANY NAME
STREET ADRESS
CITY
STATE
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.
14
Facsimile No: (714) 522-8133
Paste Paste
3. How did you learn about this product:
Other ( )
4. Most favored points are:
MODEL NO.
YEAR
SERIAL NO.
ZIP CODE
20-29 30-39
Paste Paste
Magazine
From Dealer
Newspaper
Store Display
Catalog
Design
Features
Size
Price
Makita Brand
Married
AREA
CODE
PHONE
40-49 50-60
Paste Paste
Radio
Exhibition
From Friend
Previous Usage
Other ( )
Repair Service
Durability
Power
Other ( )
STATUS SEX
M F
Single
Over 60
Paste Paste