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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| Subtotal |
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| Your State & Local Sales Tax |
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| Shipping & Handling | 6.95 |
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| Total Enclosed |
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3.Method of payment (check one) |
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Check of Money Order enclosed (NO C.O.D.SHIPMENTS) |
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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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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:
Mr.
Mrs.
Ms.
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First | Last |
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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 SERVICE AND TECHNOLOGY COMPANY
ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
In CANADA, please contact your local Panasonic dealer for more information on Accessories.
