Others
Please photocopy this form when placing
an
order.
1.
Digital Camera Model #
2.
Items Ordered
Accessory
# Description
Price Each
Quantity
Total
Price
Subtotal
Your State & Local Sales
Tax
Shipping & Handling
6.95
Total Enclosed
3.
Method
of
payment (check one)
o Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
o
VISA
Credit Card #
o MasterCard Expiration Date _
o Discover Customer Signature _
Phone#:
Day
Last
Make Check or Money Order to: PANASONIC ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship
To:
Mr.
Mrs.
Ms.
_
First
Street Address
Night
TO
OBTAIN
ANY
OF OUR DIGITAL CAMERAACCESSORIES YOU CAN DO ANY OF
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-332-5368
[6AM-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
City State
Zip
(ENG) VQT2G33
29
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