Please photocopy this form when placing an order, Palmcorder model, Items ordered – Panasonic PV-DV901 User Manual
Page 60: Description, Price each, Total price, Subtotal, Method of payment (check one), Visa credit card, Mastercard expiration date
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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
3. Method of payment (check one)
n Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
□ VISA
Credit Card # _______________________
□ MasterCard
Expiration Date______________________
□
Discover
6.95
Customer Signature
Make Check or Money Order to: PANASONIC ACCESSORIES
(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 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
60
For assistance, please call ; 1-800-211-PANA(7262) or