Manual

Please photocopy this form when placing an order.

1. 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)

[] Check of Money Order enclosed (NO C.O.D.SHIPMENTS)

[] VISA Credit Card #

5.00

[] MasterCard Expiration Date

[] Discover Customer Signature

Make Check or Money Order to: MATSUSHITA 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 DIGITAL CAMERA ACCESSORIES YOU CAN DO ANY OF THE

FOLLOWING:

VISIT YOUR LOCAL PANASONIC DEALER

CALL PANASONIC'S ACCESSORY ORDER LINE AT 1-800-272-7033 [8:30 AM-8 PM M-F, EST]

MAIL THIS ORDER TO: PANASONIC SERVICES COMPANY ACCESSORY ORDER OFFICE

20421 84th Avenue South Kent, WA. 98032