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LSQT1561
Accessory Order Form (For USA and Puerto Rico Customers)
TO OBTAIN ANY OF OUR 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-6 PM M-F, PACIFIC TIME]
OR
MAIL THIS ORDER TO: PANASONIC SERVICE AND TECHNOLOGY COMPANY
ACCESSORY ORDER OFFICE
20421 84th Avenue South Kent, WA. 98032
Ship To:
Mr.
Mrs.
Ms.
First Last
Street Address
City State Zip
Phone#:
Day
( )
Night
( )
4. Shipping information (UPS delivery requires complete street address)
Please photocopy this form when placing an order.
3. Method of payment (check one)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
MasterCard
Make Check or Money Order Payable to: PANASONIC ACCESSORIES
(Please do not send cash)
2. Items Ordered
QuantityAccessory # Price Each Description
Total Price
6.95
Subtotal
Your State & Local Sales Tax
Shipping & Handling
Total Enclosed
1. Model #
Discover
Expiration Date
Credit Card #
Customer Signature
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