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Palmcorder Accessory Order Form
Please photocopy this form when placing an order.
1. Palmcorder Model #
_
2. Items Ordered
Accessory #
Description
Price Each
Quantity
Total Price
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
5.00
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: MATSUSHITA ACCESSORIES
(Please do not send cash)
4. Shipping information (UPS delivery requires complete street address)
Ship To:
Mr.
Mrs.
First
Last
Phone #:
Day
{
)
Street Address
. Night
(
)
City
State
Zip
TO OBTAIN ANY OF OUR OMNIMOVIE/PALMCORDER 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
45
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