141. This product was purchased from:Home CenterHardware/Lumber StoreTool DistributorIndustrial SupplyConstruction SupplyOther ( )3. How did you learn about this product:MagazineFrom DealerNewspaperStore DisplayCatalogRadioExhibitionFrom FriendPrevious UsageOther ( )2. Use of the product is intended for:Construction TradeIndustrial MaintenanceHome MaintenanceHobbyOther ( )4. Most favored points are:Repair ServiceDurabilityPowerOther ( )DesignFeaturesSizePriceMakita Brand5. Any comments:MAIL THIS PORTIONYour 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 NAMESTREET ADRESSCITYSTATEAGE:ZIP CODE PHONEAREACODESTATUSMarriedSEXM FSingleMONTH DAY YEARUnder 19 20-29 30-39 40-49 50-60 Over 60Please return this portion by facsimile or mail.Facsimile No: (714) 522-8133Paste Paste Paste Paste Paste Paste Paste PastePaste Paste Paste Paste Paste PastePaste Paste Paste Paste Paste Paste