PRINTED ORDER FORM: to Yoko Trading (eBay: yokodana)
ITEM/CATALOG NUMBER: ____________________
ITEM DESCRIPTION:__________________________________________
NAME ON CARD / BILL TO::____________________________________________
PAYMENT METHOD (CHOOSE ONE): Check || Money Order || Credit Card (select type below) || Paypal ||Other
CARD TYPE (Circle One): MASTERCARD / / VISA / / AMERICAN EXPRESS // DISCOVER
CREDIT CARD NUMBER: __________________________________________(PAYPAL--DO
NOT ENTER HERE)
EXPIRATION DATE (MONTH/YEAR):____________________
SECURITY NUMBER(CIV):____________
(CIV: For Visa, MasterCard & Discover, last 3 numbers printed in signature
block;AMEX: 4 digits on front)
Signature:_______________________
Merchandise Total:________________Adjusted
Shipping/Insurance:____________TOTAL:________
EMAIL:(WE NEED THIS ONLY TO CONTACT YOU --IF NEED BE -- ABOUT
THIS ORDER)___________________
TELEPHONE: (We will not contact you unless needed for this order; also used
for UPS shipments)
___________________________________
Billing Address: (Address of cardholder):
____________________________________________________
____________________________________________________
__________________________POSTAL ZIP CODE: __________________
Ship To: (IF DIFFERENT THAN BILLING ADDRESS ABOVE, OTHERWISE LEAVE BLANK)
____________________________________________________
____________________________________________________
__________________________POSTAL ZIP CODE: __________________
FAX to: (Toll Free in USA)+866-554-8504
OR, Make payable to/MAIL
to:
Yoko Trading
4 Medill Lane
Newark DE 19711 USA