Accessory order form – Panasonic HC-V130K User Manual

Page 25

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25

SQT0034

Accessory Order Form

TO OBTAIN ANY OF OUR 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

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)

American Express

VISA

MasterCard

(Please do not send cash)

2. Items Ordered

Quantity

Accessory #

Price Each

Description

Total Price

$6.95

Subtotal

Your State & Local Sales Tax

Shipping & Handling

Total

1. Model #

Discover

Expiration Date

Credit Card #

Customer Signature

HC-V130_P_SQT0034_mst.book 25 ページ 2013年12月6日 金曜日 午後2時1分

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