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Accessory Order Form
Ship To:
Mr.
Mrs.
Ms.
First Last
Street Address
City State Zip
Phone #:
Day ( )
Night ( )
4. Shipping information (UPS delivery requires complete street address)
Please photocopy this form when placing an order.
3. Method of payment (check one)
Check or 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)
1. SD Media Storage Model #
2. Items Ordered
TO OBTAIN ANY OF OUR SD MEDIA STORAGE 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
QuantityAccessory # Price EachDescription Total Price
6.95
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
PT1.p57-62.p65 2003/01/14, 12:3757