Tape Here
Remove From Booklet or Tear Along Dotted Line
Fold Along This Line Last
First Name
Initial
Last Name
Street
City
Apt. No.
State
ZIP Code
1.
Mr.
2.
Mrs.
3.
Ms.
4.
Miss
Date of Installation:
Month
Day
Year
Date of birth of person
whose name appears above:
Month
Year
Important! For proper registration, please fill in the
model number, and serial number of this product:
A. Model Number:
B. Serial Number:
What type of product is this?
A. Price paid for this product (excluding installation charges
and sales tax):
B. Price paid for installation:
Name of company that sold you this product:
When did you acquire your product?
1. Upon purchase of a new dwelling.
2. To replace an older system of the same brand.
3. To replace an older system of another brand.
4. Within a year after purchasing a dwelling with no central air.
5. 2-4 years after buying a dwelling with no central air system.
6. Over 4 years after buying a dwelling with no central air system
.
If you replaced an older system, approximately how old was
that system?
1. Don’t know
2. 1-5 years
3. 6-8 years
4. 9-11 years
5. 12-14 years
If this is a replacement, what brand did you previously own?
1. Central Air Conditioner
2. Gas Furnace
3. Oil Furnace
$
.00
$
.00
1. Amana
2. Bryant
3. Carrier
4. Day & Night
5. Heil
6. Janitrol
7. Lennox
8. Payne
9. Rheem
10. Ruud
11. Synder
12. Tempstar
13. Trane
14. York
15. Other __________
6. 15-17 years
7. 18-20 years
8. 21-24 years
9. Over 24 years
What factors most influenced your selection of this product?
(Check a maximum of two.)
1. Brand reputation
2. Dealer reputation
3. Previous experience with products of this brand
4. Previous experience with this dealer
5. Price
Excluding yourself, what is the SEX and AGE (in years)
of children and other adults living in your household?
Marital Status:
Occupation:
Which group describes your annual family income?
1. Under $15,000
2. $15,000-$19,999
3. $20,000-$24,999
4. $25,000-$29,999
5. $30,000-$34,999
6. $35,000-$39,999
Education: (please check those which apply)
Which credit cards do you use regularly?
For your primary residence, do you:
1. No one else in household
1. Married
2. Divorced/Separated
3. Widowed
4. Never Married (Single)
Homemaker
Professional/Technical
Upper Management/Executive
Middle Management
Sales/Marketing
Clerical or Service Worker
Tradesman/Machine Oper./Laborer
Retired
Student
. . . . . . . . . . . .
. . . . . . . .
. . . . .
. . . . . . . . .
. . . . . . . . . . .
. . . . . . .
. . .
. . . . . . . . . . . . . .
. . . . . . . . . . . . . .
Self Employed/Business Owner. . . . .
7. $40,000-$44,999
8. $45,000-$49,999
9. $50,000-$59,999
10. $60,000-$74,999
11. $75,000-$99,999
12. $100,000 & over
Some High School or Less
Completed High School
Vocational/Technical School
Some College
Completed College
Some Graduate School
Completed Graduate School
1. American Express, Diners Club
2. MasterCard, Visa, Discover
3. Department Store, Oil Company, etc.
4. Do not use credit cards
1. Own a House?
2. Own a Townhouse or Condominium?
3. Rent a House?
4. Rent an Apartment, Townhouse or Condominium?
10.
. . . . . .
. . . . . . . .
. . . . . .
. . . . . . . . . . .
. . . . . . . . .
. . . . . . . .
. . . . . .
10
9
8
7
6
5
4
3
2
1
18
17
16
15
14
13
11
6. Energy efficiency
7. Location of dealer
8. Dealer’s installation policy
9. Friend’s/relative’s recommendation
10. Contractor’s/dealer’s recommendation
11. Other ____________________
1.
1.
Age
years
Female
2.
Male
2.
years
You
1.
2.
3.
4.
5.
6.
7.
Spouse
12
You
1.
2.
3.
4.
5.
6.
7.
8.
9.
Spouse
1.
1.
Age
years
Female
2.
Male
2.
years
1 9
Please send products and other correspondence to:
Payne Heating & Cooling
Consumer Relations Department
P.O. Box 4952
Syracuse, NY 13221
PLACE
FIRST-CLASS
STAMP
HERE
P.O. BOX 173246
DENVER, CO 80217-3246
Thanks for taking the time to fill out this questionnaire. Your answers will be used for market research studies and reports — and will help us better serve you in the future.
They will also allow you to receive important mailings and special offers from a number of fine companies whose products and services relate directly to the specific interests,
hobbies, and other information indicated above. Through this selective program, you will be able to obtain more information about activities in which you are involved and less
about those in which you are not. Please check here if, for some reason, you would prefer not to participate in this opportunity.
If you have comments or suggestions about our product please write to:
To help us understand our customers’ lifestyles, please indicate the interests and activities in which you or your
spouse enjoy participating on a regular basis:
Please check all that apply to your household:
Using the numbers in the above list, please
indicate the 3 most important activities for:
01. Bicycling Frequently
02. Golf
03. Physical Fitness/Exercise
04. Running/Jogging
05. Snow Skiing Frequently
06. Tennis Frequently
07. Camping/Hiking
08. Fishing Frequently
09. Hunting/Shooting
10. Power Boating
11. Sailing
12. House Plants
13. Grandchildren
14. Needlework/Knitting
15. Vegetable Gardening
16. Flower Gardening
17. Sewing
35. Gourmet Cooking
36. Wines
37. Coin/Stamp Collecting
38. Collectibles/Collections
39. Our Nation’s Heritage
40. Real Estate Investments
41. Stock/Bond Investments
42. Entering Sweepstakes
43. Casino Gambling
44. Science Fiction
45. Wildlife/Environmental Issues
46. Dieting/Weight Control
47. Science/New Technology
48. Self Improvement
49. Walking for Health
50. Watching Sports on TV
18. Crafts
19. Automotive Work
20. Electronics
21. Home Workshop/Do It Yourself
22. Recreational Vehicles
23. Stereo, Records/Tapes/CDs
24. Buy Pre-Recorded Videos
25. Avid Book Reading
26. Bible/Devotional Reading
27. Health/Natural Foods
28. Photography
29. Home Furnishing/Decorating
30. Attending Cultural/Arts Events
31. Fashion Clothing
32. Fine Art/Antiques
33. Foreign Travel
34. Travel in the USA
You
Spouse
Payne Heating & Cooling
Consumer Relations Department
P.O. Box 4952
Syracuse, NY 13221
or call 1-800-428-4326
1. Regularly Purchase Items
Through the Mail
2. Military Veteran in Household
3. Member of Frequent Flyer Program
4. Support Health Charities
5. Subscribe to Cable TV
6. Have a Microwave Oven
7. Have a CD Player
8. Have a VCR
9. Use a Personal Computer
10. Have a Dog
11. Have a Cat
19
20
21
Fold Along This Line First
4. Fan Coil
5. Heat Pump
6. Thermostat
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7
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