Manual

Accessory Order Form (For USA and Puerto Rico Customers)

Please photocopy this form when placing an order.

1. Model #

2. Items Ordered

Accessory # Description Price Each Quantity Total Price

Shipping & Handling

Subtotal

Your State & Local Sales Tax

Total

3. Method of payment (check one)

[] American Express

[] VISA Credit Card #

[] MasterCard Expiration Date

[] Discover Customer Signature

(Please do not send cash)

4. Shipping information (UPS delivery requires complete street address)

Last Phone#:

Day ( )

Street Address

Night ( )

City State Zip

Ship To:

Mr.

Mrs.

Ms.

First

$6.95

TO OBTAIN ANY OF OUR ACCESSORIES YOU CAN DO ANY OF

THE FOLLOWING:

VISIT YOUR LOCAL PANASONIC DEALER

CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800_332-5368

[6 AM-6 PM M-E PACIFIC TIME]

MAIL THIS ORDER TO: PANASONIC NATIONAL PARTS CENTER

20421 84th Ave. S., Kent, WA 98032

In CANADA, please contact your local Panasonic dealer for more information on

Accessories.

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