Panasonic HX-DC3 owner manual Accessory Order Form, For USA and Puerto Rico Customers

Accessory Order Form

(For USA and Puerto Rico Customers)

Please photocopy this form when placing an order.

1.Model #

2.Items Ordered

Accessory # Description Price Each Quantity Total Price

				Shipping & Handling			$6.95
					Subtotal
			Your State & Local Sales Tax
3. Method of payment (check one)						Total
	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 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

In CANADA, please contact your local Panasonic dealer for more information on Accessories.

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