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VQT0S19
Digital Camera Accessory Order Form
(For USA Customers)
Please photocopy this form when placing an order.
1. Digital Camera Model #
2. Items Ordered
3. Method of payment (check one)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA Credit Card #
MasterCard Expiration Date
Discover Customer Signature
Make Check or Money Order to: PANASONIC ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
In CANADA, please contact your local Dealer for more information on
Accessories.
Accessory #
Description Price Each Quantity Total Price
Subtotal
Your State & Local Sales Tax
Shipping & Handling 6.95
To t a l E n c l o s e d
Ship To:
Mr.
Mrs.
Ms.
First Last Phone#:
Day ( )
Street Address
Night ( )
City State Zip
TO OBTAIN ANY OF OUR DIGITAL CAMERA 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-5 PM M-F, 6 AM-10:30 AM SAT, PACIFIC TIME]
OR
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
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