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Panasonic HM-TA2 - Accessory Order Form (for USA and Puerto Rico Customers)

Panasonic HM-TA2
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VQT3N87 99
In CANADA, please contact your local Panasonic dealer for more
information on Accessories.
Accessory Order Form (For USA and Puerto
Rico Customers)
TO OBTAIN ANY OF OUR ACCESSORIES YOU CAN DO ANY OF
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC’S ACCESSORY ORDER LINE AT 1-800-332-5368
[6 AM-6 PM M-F, PACIFIC TIME]
OR
MAIL THIS ORDER TO: PANASONIC SERVICE AND TECHNOLOGY COMPANY
ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
Ship To:
Mr.
Mrs.
Ms.
First Last
Street Address
City State Zip
Phone#:
Day
( )
Night
()
4. Shipping information (UPS delivery requires complete street address)
Please photocopy this form when placing an order.
3. Method of payment (check one)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
MasterCard
Make Check or Money Order Payable to: PANASONIC ACCESSORIES
(Please do not send cash)
2. Items Ordered
QuantityAccessory # Price EachDescription Total Price
6.95
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
1. Model #
Discover
Expiration Date
Credit Card #
Customer Signature
HM-TA20&TA2_P&PC-VQT3N87_mst.book 99 ージ 2011年4月22日 金曜日 午後12時11

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