Panasonic PV-GS29, PV-GS39 Visa, Credit Card #, AM-5 PM M-F, 6 AM-1030 AM SAT, Pacific Time

Please photocopy this form when placing an order.

1.Camcorder Model #

2.Items Ordered

Accessory# Description Price Each Quantity Total Price

Subtotal

Your State & Local Sales Tax

Shipping & Handling6.95

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.

First	Last	Phone	#:
		Day	(	)
Street	Address
		Night	(	)
City	State	Zip

TO OBTAIN ANY OF OUR CAMCORDER 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

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