Accessory Order Form (For Usa Customers) - Panasonic SDR-SW20P Operating Instructions Manual

Accessory Order Form
Please photocopy this form when placing an order.
1. Model #
2. Items Ordered
Accessory #
3.Method of payment (check one)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
MasterCard Expiration Date
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
In CANADA, please contact your local Panasonic dealer for more information
on Accessories.
Description Price Each
Credit Card #
Customer Signature
Last
State
THE FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
[6 AM-6 PM M-F, PACIFIC TIME]
ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
(For USA Customers)
Quantity
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
Zip
OR
OR
Total Price
Subtotal
6.95
Phone#:
Day ( )
Night ( )
VQT1M21
103