
Digital Camera Accessory Order Form
Please photocopy this form when placing an order.
1.Digital Camera Model #
2.Items Ordered
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 | Subtotal | 
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 | Your State & Local Sales Tax | 
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 | Shipping & Handling | 6.95 | 
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| 3. Method of payment (check one) | 
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 | Check of Money Order enclosed (NO C.O.D.SHIPMENTS) | 
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 | VISA | Credit Card # | 
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 | MasterCard | Expiration Date | 
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| Discover | Customer Signature | 
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 | Make Check or Money Order to: PANASONIC ACCESSORIES | |||||||||||
| (Please do not send cash) | 
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| 4. Shipping information (UPS delivery requires complete street address) | |||||||||||||
| Ship To: | 
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| Mr. | 
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| Mrs. | 
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| Ms. | 
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 | Phone#: | 
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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 
[6 
OR
MAIL THIS ORDER TO: PANASONIC SERVICE AND TECHNOLOGY COMPANY
ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
(ENG) VQT2X16 39