| FIREARM INFORMATION |
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| PURCHASER INFORMATION |
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(Example: 12345) |
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(Example: 812-555-1212) |
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(Example: name@domain.com) |
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WARRANTY ASSIGNED TO (if different from purchaser)
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(Example: 12345) |
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(Example: 812-555-1212) |
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| DEALER’S NAME AND ADDRESS |
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(Example: 12345) |
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(Example: 812-555-1212) |
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| Your answers to the following questions will help us better serve you. |
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Yes No
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Yes No
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Yes No
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Which firearms/outdoor magazines do you read?
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Your gender:
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