Product Registration

1. Title:   Mr.    Mrs.    Ms.    Miss

   Purchaser Name:     First:		Initial:		Last:
   Business Name:
   Business Address:   Street:				Suite      No:
   City:				State:	Select a state Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Non-U.S./Non-Canadian International
   Zip Code:

 
2. Email Address:
   YES! I would like to receive information from Panasonic about special offers, promotions
   and new product information via e-mail
   
 
3. Business Telephone Number: ( ) -
   
 
4. Date of purchase:  Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2009 2008 2007 2006 2005
   
 
5. A) Model number: (refer to operating manual or box)
   
   B) Serial number: (refer to the product)
   
 
6. Price paid: (excluding service contract, shipping and taxes) $ .00
   
 
7. Did you purchase or receive an extended service contract with your product?
   

   Yes

   No

 
8. How many telephones did you buy? sets
   
 
9. Is this current purchase a:
   Replacement purchase?
   Additional purchase to an existing system?
   First-time purchase?
   
 
10. If this purchase is a replacement, what brand of telephone system was installed previously?
    

    AT&T Avaya Comdial Intertel Mitel NEC

    Northern Telecom Panasonic Samsung Toshiba Other

 
11. Type of store where purchased?
    

    Alarm and security company Business center Computer chain Interconnect company Office equipment dealer

    Office superstore Telephone company Telephone specialty store Other

 
12. Name of store where purchased:
    
 
13. What were the two (2) most important features that influenced your selection of this product?
    
    a.) For model numbers KX-TA624 or KX-TA1232: (check up to 2)
    

    Call park Call pick-up Call transfer Caller ID Camp on Conference calling Connecting a single telephone Data security Direct inward system access Executive override Flexible key assignment

    Flexible station numbering Message waiting Night (Time) service Paging Power failure transfer SMDR Speed dialing Station name display Toll restriction Trunk assignment Other

  b.) For model numbers KX-TD1232, KX-TD816 or KX-TD308: (check up to 2)

Automatic route selection Caller-ID Direct inward system access Extra device port Hybrid station ports Music over paging

Remote administration Toll restriction Verified account codes Voice mail integration Other

 
14. Reason for purchase: (check all that apply)

    Upgrade from existing system New company New office

    Home/Office use Home/Personal use Other

 
15. What other brands were seriously considered before selecting this Panasonic model system?

    Avaya Comdial Iwatsu NEC Nortel

    Toshiba Vodavi Other No other brands considered

 
16. Please rate the following as they apply to this Panasonic system by checking the appropriate rating (Excellent, Good, Poor):
    

    	Excellent	Good	Poor
    Total performance
    Features
    Design
    Ease of Operation
    Value

     
17. How many central office lines are connected to this Panasonic system?
    

    1 line 2 lines 3 lines 4 lines 5 lines 6 lines

    7 lines 8 lines 9 lines 10 lines 11 lines 12 lines or more

 
18. How many telephones are connected to your Panasonic system?
    

    4 or less 5-8 9-12 13-16 17-20

    21-24 25-28 29-32 33 or more

 
19. Which of the following devices are used with this Panasonic system?
    

    Answering machine Automated attendant Back up batteries Background/Music on-hold source Call accounting system Cordless phone Data terminal Doorphone  sets External paging system Facsimile machine Headset  sets Modem  sets Personal computer SMDR printer Standard telephone Voice Mail system KX-T30865  sets KX-T7020  sets KX-T7030  sets KX-T7040  sets

    KX-T7050  sets KX-T7055  sets KX-T7130  sets KX-T7135  sets KX-T7320  sets KX-T7335  sets KX-T7350  sets KX-T7420  sets KX-T7425  sets KX-T7431  sets KX-T7433  sets KX-T7436  sets KX-T7440  sets KX-T7441  sets KX-T7453  sets KX-T7456  sets Other None

 
20. Which of the following optional feature cards/modules did you purchase with your Panasonic system?
    

    A. With model KX-TA624:

    B. With model KX-TA1232:

    Direct Inward System Access       (DISA) KX-TA62491 Caller ID KX-TA62493

    Direct Inward System Access       (DISA) KX-TA123291 Caller ID KX-TA123293




C. With model KX-TD1232:

D. With model KX-TD816:

Direct Inward System Access       (DISA) KX-TD191 Caller ID KX-TD193 TI Expansion Module KX-TD187

Caller ID KX-TD193

 
21. Is there a Voice Processing System installed with this phone system?
    

    Yes

    No

 
22. If so, what brand/system is installed?
    
 
23. If not, do you plan to install one within the next 12 months?
    

    Yes

    No

 
24. Is your system installed in a business or a home?
    

    Business Home (If installed in home, do not answer questions 25 - 27)

 
25. What is the primary business activity of your firm? (check only one)
    

    Advertising/Public Relations Architecture, Engineering, Construction Banking, Insurance, Financial or       Consulting Services Education Government Health Care, Hospital, Medical Services Legal Services

    Manufacturer/Distributor Real Estate Retailer Service business including, Travel,       Transportation, Communications, or Utilities Wholesaler Other

 
26. How many employees does your firm have?
    

    1-4 5-9 10-19 20-49

    50-99 100-499 500-999 1000 or more

 
27. Which group describes your firm's annual revenue?
    

    Under $100,000 $100,000-$249,999 $250,000-$499,999 $500,000-$999,999

    $1,000,000-$4,999,999 $5,000,000-$9,999,999 $10,000,000 or over

Your Privacy Rights This statement discloses the privacy practices of this Product Registration website. We believe you should know: 1. What information this site gathers about you 2. What this site does with the information it tracks 3. With whom this site shares the information it gathers We collect personal information about our users only during product registration. We do not use cookie technology to track your movements. We respect your right to privacy. As part of the entry process, we give you the opportunity to decline to receive any communications from other parties to whom we may provide such information. The data we collect is used in the aggregate to give us demographic information about the entire audience registering their products. We use this to understand that audience and to improve our offerings to you, our customers. The personal information you provide - name, address, etc. - allows us to inform you of additional special offers which may be forthcoming, and to send you coupons, or notify you of products and services of our affiliates that relate directly to your specific interests, hobbies or other information you have given. Security All data is stored in a highly secure database with state of the art backup and firewall technologies. It is not accessible to any unauthorized parties. This means that your information is kept safe, and is only disclosed to selected third parties to provide you with valuable information and special offers. I do not want to receive coupons, mailings, or other special offers

Failure to submit this registration will not diminish your warranty rights.

---

If you have questions or concerns about this site, our privacy policies, data use, or wish to change your options, click here.

---