Accessory Order Form - Panasonic SV-PT1PP Operating Instructions Manual

Please photocopy this form when placing an order.
1. SD Media Storage Model #
2. Items Ordered
Accessory # Description
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)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
Ms.
First
Street Address
City
TO OBTAIN ANY OF OUR SD MEDIA STORAGE ACCESSORIES YOU CAN DO ANY OF
VISIT YOUR LOCAL PANASONIC DEALER
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]
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY
20421 84th Avenue South Kent, WA. 98032
PT1.p57-62.p65

Accessory Order Form

Price Each Quantity
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
Phone #:
Last
Day (
Night (
State Zip
THE FOLLOWING:
OR
OR
ORDER OFFICE
57
Total Price
6.95
)
)
57
2003/01/14, 12:37