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Camcorder Accessory Order Form (For USACustomers)
Please photocopy this form when placing an order
1 Palmcorder Model #
2. Items Ordered
Accessory # Description Price Each Quantity Total Price
Subtotal
Your State & Local Sales "-_
Shipping & Handling 695
Total Enclosed
;3 Method of payment (check one)
[] Check of Money Order enclosed (NO C.O DSHIPMENTS)
[] VISA Credit Card #
[] MasterCard Expiration Date
[] Discover Customer Signature
Make Check or Money Order Payable to: PANASONIC ACCESSOFJlES
(Please do not send cash)
4 Shipping information (UPS delivery requires complete street address)
Ship TO:
Mr.
Mrs.
Ms,
First Last Phon_:
Day (
Street Address
Night (
City State Zip
TO OBTAIN ANY OF OUR PALMCORDER ACCESSORIES YOU CAN DO ANY OF
THE FOLLOWING:
VlSITYOUR 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
In CANADA,please eentaci your local Pan_Lsoniodealer for more informationon Accessories.
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