Panasonic HMTA1 HMTA1 User Guide - Page 72

Accessory Order Form For USA and Puerto, Rico Customers, In CANADA

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Accessory Order Form (For USA and Puerto Rico Customers) 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 6.95 3. Method of payment (check one) Total Enclosed Check of Money Order enclosed (NO C.O.D.SHIPMENTS) VISA Credit Card # MasterCard Expiration Date Discover Customer Signature Make Check or Money Order Payable to: PANASONIC ACCESSORIES (Please do not send cash) 4. Shipping information (UPS delivery requires complete street address) Ship To: Mr. Mrs. Ms. First Street Address City Last State Zip Phone#: Day ( ) Night ( ) TO OBTAIN ANY OF OUR 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-6 PM M-F, PACIFIC TIME] OR MAIL THIS ORDER TO: PANASONIC SERVICE AND TECHNOLOGY COMPANY ACCESSORY ORDER OFFICE 20421 84th Avenue South Kent, WA. 98032 In CANADA, please contact your local Panasonic dealer for more information on Accessories. 72 VQT2Z95

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72
VQT2Z95
In CANADA, please contact your local Panasonic dealer for more
information on Accessories.
Accessory Order Form (For USA and Puerto
Rico Customers)
TO OBTAIN ANY OF OUR 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-6 PM M-F, PACIFIC TIME]
OR
MAIL THIS ORDER TO: PANASONIC SERVICE AND TECHNOLOGY COMPANY
ACCESSORY ORDER OFFICE
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)
Check of Money Order enclosed (NO C.O.D.SHIPMENTS)
VISA
MasterCard
Make Check or Money Order Payable to: PANASONIC ACCESSORIES
(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 Enclosed
1. Model #
Discover
Expiration Date
Credit Card #
Customer Signature