Palmcorder Accessory Order Form
IIIIIII
Please photocopy this form when placing an order.
Accessory #
1. Palmcorder Model #
2. Items Ordered
Description
3. Method of payment (check one)
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[]
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Price Each
Quantity
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
Check or Money Order enclosed (NO C,O.D,SHIPMENTS)
VISA Credit Card #
MasterCard
Discover
Total Price
5.00
Expiration Date
Customer Signature
Make Check or Money Order to: MATSUSHtTA ACCESSORIES
(Please do not send cash)
4, Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs_
Ms.
First Last Phone #:
Day ( )
Street Address
Night ( )
City State Zip
TO OBTAIN ANY OF OUR OMNIMOVIEJPALMCORDER ACCESSORIES YOU CAN DO ANY OF
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC'S ACCESSORY ORDER LINE AT t-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
77
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