Panasonic KX-TD500 - Manual (Page 16)

Panasonic
KX-TD500 CPU & SPARES KIT
ORDER FORM
TO: NPC ORDER DESK (1-800-237-9080)
ATTN: Wanda Connors
I M P O R T A N T
You must purchase a KX-TD500 spares kit with the purchase of your first CPU. One spares kit purchase
permitted per dealer. Only one CPU purchase permitted with the purchase of each KX-TD500 Basic Shelf.
Instructions to order a KX-TD500 CPU or Spares Kit:
1. Complete all information on this form. Items 1 through 5
2. Attach a copy of the invoice you received from your Panasonic distributor that clearly shows your dealership’s
name and address, distributor name and address, the Basic Shelf, model number (KX-TD500), quantity, and
date of purchase.
3. Shipping cost not included in CPU or SPARES KIT costs.
4. Fax to 1-800-237-9080
.
1. FROM
YOUR DEALERSHIP NAME:________________________________________________________________
STREET:___________________________________________________________________________________________
CITY:_______________________________________________________STATE:_________ZIP CODE:_______________
RETURN FAX #: __________________PHONE #:_____________________DATE: ________________________________
DEALERSHIP ID (9 Digits): _____________________________CONTACT NAME:________________________________
2. SHIP-TO ADDRESS
NAME: ____________________________________________________________
STREET ADDRESS:
CITY: STATE: ZIP CODE:
3. PURCHASED FROM
DISTRIBUTORS NAME: ___________________________________________________
STREET: ____________________________CITY: _____________________________STATE: ________ZIP:_________
KX-TD500 SERIAL NUMBER: ____________________________ DATE OF PURCHASE: _______________
4. METHOD OF PAYMENT
PASC ACCOUNT VISA MASTER AMEX DISCOVER
PASC ACCOUNT OR CREDIT CARD NUMBER: ___________________________________________EXPIRATION DATE __/__
5. METHOD OF SHIPMENT
UPS Ground UPS Blue UPS Red Other______________
Part Number Price QTY PO #
KX-TD50101-1 CPU Card
UG-KX-TD500 User Guide $700.00 1
SPARES KIT $1795
CUSTOMER CONTROL #:
(TO BE FILLED IN BY NPC STAFF)
NPC USE:
Keyed By: Faxed Date:
030999