Panasonic VQT4T99, DMCTS25A, F0113YS0, DMCTS5A, DMCTS5D Digital Camera Accessory Order Form, Visa

Digital Camera Accessory Order Form

Please photocopy this form when placing an order.

1.Digital Camera Model #

2.Items Ordered

Accessory #	Description	Price Each		Quantity	Total Price
			Shipping & Handling		$6.95
				Subtotal
		Your State & Local Sales Tax
				Total

3.Method of payment (check one)

American Express

VISA	Credit Card #
MasterCard	Expiration Date
Discover	Customer Signature
(Please do not send cash)

4. Shipping information (UPS delivery requires complete street address)

Ship To:
Mr.
Mrs.
Ms.					Phone#:
	First	Last
					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-6 PM M-F, PACIFIC TIME]

OR

MAIL THIS ORDER TO: PANASONIC NATIONAL PARTS CENTER

20421 84th Ave S., Kent, WA 98032

38 VQT4T99 (ENG)