Palmcorder Accessory Order Form

Please photocopy this form when placing an order.

1.Palmcorder Model #

2.Items Ordered

Accessory #

Description

Price Each

Quantity

Total Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Subtotal

 

 

 

Your State & Local Sales Tax

 

 

 

 

Shipping & Handling

 

 

 

 

6.95

 

 

 

Total Enclosed

 

 

 

 

 

 

3. Method of payment (check one)

 

 

 

 

Check of Money Order enclosed (NO C.O.D.SHIPMENTS)

 

 

VISA

Credit Card #

 

 

 

MasterCard

Expiration Date

 

 

Discover

Customer Signature

 

 

 

Make Check or Money Order to: PANASONIC ACCESSORIES

(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 PALMCORDER 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-5 PM M-F, 6 AM-10:30 AM SAT, PACIFIC TIME]

OR

MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY ORDER OFFICE

20421 84th Avenue South Kent, WA. 98032

94 Forassistance, pleasecall: 1-800-211-PANA(7262)orsende-mailto:consumerproducts@panasonic.com

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Panasonic PV-DV702 operating instructions Palmcorder Accessory Order Form, Visa