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Registration Card
Name__________________________________________________________
Address________________________________________________________
City__________________ State___________________ Zip____________
Phone Number: Home (
)_____________ Office (
)______________
Place of Purchase__________________________ Date of Purchase______
Purchase Model___________________
Purchase Price__________
Vehicle Make___________________ Model:_________________________
How did you hear about this product?_______________________________
Firstech Inc.
230 E. Potter Suite 8
Anchorage, AK 99518
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