96
SQT0359 (ENG)
Others
Digital Camera Accessory Order Form
(For USA Customers)
Please photocopy this form when placing an order.
1. Digital Camera Model #
2. Items Ordered
Accessory #
Description
Price Each
Quantity
Total Price
Shipping & Handling
$6.95
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)
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
YOU MAY CONTACT US DIRECTLY AT:
1-800-237-9080 (FAX ONLY)
OR
MAIL THIS ORDER TO: PANASONIC NATIONAL PARTS CENTER
20421 84th Avenue South, Kent, WA 98032