Accessory Order Form (For Usa And Puerto Rico Customers) - Panasonic HDC-SD80P Owner's Manual

Accessory Order Form
Please photocopy this form when placing an order.
1. Model #
2. Items Ordered
Accessory # Description
3. Method of payment (check one)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
MasterCard
Discover
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.
First
Street Address
City
TO OBTAIN ANY OF OUR ACCESSORIES YOU CAN DO ANY OF
CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-332-5368
MAIL THIS ORDER TO: PANASONIC SERVICE AND TECHNOLOGY COMPANY ACCESSORY ORDER OFFICE
In CANADA, please contact your local Panasonic dealer for more information on
Accessories.
150
VQT3J15
(For USA and Puerto Rico Customers)
Price Each
Your State & Local Sales Tax
Credit Card #
Expiration Date
Customer Signature
Last
State Zip
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
[6 AM-6 PM M-F, PACIFIC TIME]
OR
20421 84th Avenue South Kent, WA. 98032
Quantity
Subtotal
Shipping & Handling
Total Enclosed
Phone#:
Day ( )
Night ( )
Total Price
6.95