Hitachi Power Tools Canada

*1. First Name: Initial: *Last Name: *Address: Apt Number: *City: *Province: Choose Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon *Postal Code: *2. Phone *3. Email Address: (Example: yourname@yourhost.com) Yes! I want to receive offers or communications from Hitachi via e-mail. *4a. Date of Purchase:   January February March April May June July August September October November December     01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 *4b. Where did you purchase your Hitachi Tool(s) *5a. Model Number #1: *5b. Serial Number #1: 6a. Model Number #2 6b. Serial Number #2 7a. Model Number #3 7b. Serial Number #3 8a. Model Number #4 8b. Serial Number #4 9. What is the type of intended use/application for this tool? Choose Do-it-yourselfer Hobbyist Home improvement Professional Woodworking 10. What do you plan on purchasing next? Choose A. Corded Drill/Driver (A) Reciprocating Saw (A) Circular Saw (A) Miter Saw (A) Hammer Saw (A) Hammer Drill (A) Sander (A) Porta-Band (A) Right-Angle Drill (A) Impact Wrench (A) Rotary Hammer (A) Nail gun/Stapler (A) Router (A) Vacuum (A) Jig Saw (A) Other Corded Product B. Cordless Drill/Driver (B) Reciprocating Saw (B) Circular Saw (B) Combo Kits (B) Impact Wrench (B) Hammer Drill (B) Rotary Hammer (B) Right Angle Drill (B) Screw Driver (B) Other Cordless Product 11. Please select the option that best describes your ocupation Choose Residential building Remodeling/home improvement Commercial Construction Plumbing HVAC Electrical Masonry-brick/concrete Plaster/drywall installation Tile/marble/flooring Cabinet/furniture carpentry Roofing/siding/steel Other woodworking Industrial/maintenance/manufacturing Agriculture/farm use Government Automotive/boating Other commercial construction Other non-trade 12. Where do you usually purchase your Hitachi tools? Choose Contractor supply Home center Electrical supply Tool supply Lumber/building supply Woodworker supply Industrial supply Hardware store Plumbing supply Welding supply Rental Internet Mail order Don't know Received as a gift Other 13. How many power tools do you own/use? Choose 1-3 4-6 7-10 11-15 16-24 25+ 14. Please select two (2) of the following reasons that most influenced the purchase of this Hitachi tool. Reputation Tool Capability Tool Reliability Feel of Comfort Durability of the Tool Availability of the product Service of Product Price 15a. If replacing an electric tool, which brand? Choose Makita Black & Decker/DeWalt Milwaukee Skil/Bosch Ryobi Porter Cable Other 15b. If replacing a pneumatic tool, which brand? Choose Senco DeWalt ITW Paslode Stanley-Bostich Porter Cable Max Other 16. What percentage of the power tools you own are Hitachi tools? Choose 1-10% 11-25% 26-50% 51-75% 76-99% 100% First time purchase of Hitachi brand 17. Your gender: Choose Male Female * denotes required field

For warranty protection please save your dated cash register receipt as proof of purchase. If warranty service becomes necessary, your dated cash register receipt will help the authorized service provider to expedite your repairs. Serial numbers and manufacturing date codes may not be sufficient evidence of warranty coverage.