Makita 4013D Instruction Manual page 14

MAIL THIS PORTION
DATE PURCHASED
Your answer
to
the following questions are appreciated.
1. This product
was
purchased from:
0
Home Center
0
Other (
)
0
Magazine
0
Radio
0
Hardware/Lumber Store
0
From Dealer
0
Exhibition
0
Tool Distributor
0
Newspaper
0
From Friend
0
Industrial Supply
0
Store Display
0
Previous Usage
3. How did you learn of about this product:
Construction Supply
0
Catalog Other
( )
2. Use of the product i s intended for: 4. Most favored points are:
MODEL NO.
0
Construction Trade
0
industrial Maintenance
0
Home Maintenance
0
Hobby
0
Other ( )
5. Any comments:
0
Design
0
Repair Service
0
Features
0
Durability
0
Size
0
Power
0
Makita Brand
0
Price
0
Other (
)
MONTH DAY YEAR
I
SERIAL NO.
I
m
I 1
iNTL. LAST NAME / COMPANY NAME
STATUS SEX
Married Single
M F
STREET
I I l I l l I 1 l I l l I l I I
ADRESS
CITY
AREA
CODE
STATE ZIP CODE PHONE
I l l /
AGE:
0
Under 19
0
20-29
0
30-39 40-49
c ]
50-60
0
Over 60
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