Panasonic DMC-G5K, DMC-G5X Digital Camera Accessory Order Form, For USA and Puerto Rico Customers

Digital Camera Accessory Order Form

(For USA and Puerto Rico Customers)

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

(ENG) VQT4G94 51