Panasonic PalmCam SuperDISK PV-SD4090 Operating Instructions Manual page 68

Please photocopy this form when placing an order.
1. Model #
2. Items Ordered
Accessory #
Description Price Each Quantity Total Price
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
3. Method of payment (check one)
[] Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
[] VISA Credit Card #
5.00
[] MasterCard Expiration Date
[] Discover Customer Signature
Make Check or Money Order to: MATSUSHITA ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
Ms.
First Last Phone #:
Day (
Street Address
Night (
City State Zip
)
)
TO OBTAIN ANY OF OUR DIGITAL CAMERA ACCESSORIES YOU CAN DO ANY OF THE
FOLLOWING:
VISIT YOUR LOCAL PANASONIC DEALER
OR
CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-272-7033 [8:30 AM-8 PM M-F, EST]
OR
MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
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