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Palmcorder Accessory Order Form
I I
Please photocopy this form when placing an order.
1. Palmcorder Model #
2. Items Ordered
Accessory # Description Price Each Quantity Total Price
3. Method of payment (check one)
[]
Subtotal t ....
Your State & Local Sales Tax[
Shipping & Handling 5.00
Tota Ene osed
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.
Ms.
First
Street Address
City
Last
State Zip
Phone #:
Day (
Night (
)
)
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 1-800-332-5388
[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