Customer information, usage occasions, warranty identification information.
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Introduction text here. First Name Last Name Street Address City, State and Zip Date of Purchase Model No. What type of store did you purchase this [PRODUCT] in? How much did [PRODUCT] cost (excluding tax)? Please check the most important reason why you chose this product. (Check only one.) Which of the following describes this purchase of [PRODUCT]? Please check the primary occasion when you intend to use [PRODUCT](check only one.) What one factor most influenced your purchase [BRAND] [PRODUCT]? What is your birth date? Marital status: Do you have children in your household in any of the following age groups? Which group describes your annual family income? Which types of credit cards do you use regularly? For your primary residence, do you: |
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