TUN HWA ELECT. MATERIAL CO., LTD. Order Form
Printed form the internet
First name:
Last Name:
E-Mail:
Country:
Address:

Phone:
Fax:
Order Item:

Total Amount:
Order Date:

Payment Info:
Credit card type: □ VISA Card □ Master Card □ JBC
Issuer Bank:
Expiration Date: Month _______ Year ________
Credit card number: □□□□ □□□□ □□□□ □□□□
Credit card ID verification numbers : □□□
(The Verification Code is a three-digit number on the back of your credit card)
CardHolder I.D:
CardHolder Name:
Merchant Name: TUN HWA ELECT. MATERIAL CO., LTD.
Merchant NO: 42-016-0511-8
APP. Code:

(Do not infill)



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CardHolder signature
Fax This Form to : 886-4-3602-7571 or 886-4-2259-9250

TUN HWA ELECT. MATERIAL CO., LTD.
No.18, Huanhe Rd., Situn District, Taichung City 40757, TAIWAN
Tel:886-4-2254-8047 Fax:886-4-3602-7571、886-4-2259-9250
http:// www.cpu.com.tw e-mail: sales@cpu.com.tw (.html)