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 |
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| Shipping & Handling | $6.95 |
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| Subtotal |
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| Your State & Local Sales Tax |
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3. Method of payment (check one) |
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| Total |
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| American Express |
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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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(Please do not send cash) |
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4. Shipping information (UPS delivery requires complete street address) |
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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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| Day | ( | ) |
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| Street Address |
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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
[6
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.
VQT4X05 59
