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Reliance
RESPONSE FORM

Name Mr Ms
Company
Title Dept.
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City Phone:(O)
Pin Phone:(R)
State Fax No.
Country E - mail
1. PRESENT BUSINESS ACTIVITY
6.I NEED
2.I AM INTERESTED IN THE FOLLOWINGPRODUCTS
Automatic Wafer biscuit Machine
Automatic Ice Cream Cone baking Machine
Manual Ice Cream Cone baking Machine
Manual cream wafer(Biscuit) plants
Other Machines
New products
7. COMPANY INFORMATION (Selectonly one )
Our business function is mainly
Distributor Retailer
Manufacturer Consultant

Wholesaler Other(specify)
Our Annual sales US $:
3. PLEASE SEND ME THE FOLLOWING
Product Samples Delievery time
Product Specification. Project profile
Machinery Price
Others(specify)
8. OUR CUSTOMERS ARE:(SELECT ALLTHAT APPLY)
Retailers Consumers
Distributors Consultant
Wholesaler Others(specify)
4. WE ARE ENQUIRING BECAUSE(Select only one)
We have decided to buy this product
We are considering adding this as a new product Others(specify)
9. MY ROLE IN OUR COMPANY'S(TWOOR LESS)
I buy I evaluate supplier
I approve purchase
Inegotiate contracts I select supplier
5. WE PLAN TO ORDER: (Select only one)

Within 3 months Within6 to 12 months
Within3 to 6 months
Considering/ evaluating
10.Date :
(dd\mm\yy)
11
. Signature:

Your comments:

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