Others
Camcorder Accessory Order Form (For USA Customers)
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 Payable to: PANASONIC ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To: |
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Mr. |
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Mrs. |
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Ms. |
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First | Last | Phone#: |
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| Day | ( |
Street | Address |
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| Night | ( |
City | State | Zip |
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TO OBTAIN ANY OF OUR PALMCORDER ACCESSORIES YOU CAN DO ANY OF
THE FOLLOWING:
VlSITYOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC'S ACCESSORY ORDER LINE AT
[6
OR
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
In CANADA, please contact your local Panasonic dealer for more information on Accessories.
7.7
LSQT1121
