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Order
Form
Please print the order form, complete the order form and fax at 212-564-2188 or
email.
Himalayan lnternational Trading
126 Madison Avenue, New York, NY 10016
(212) 564-1468 Fax: 212-564-2188
Email: homefashionimports@att.net
Ship to:
Name:
........................................................................................................
Address:.............................................................................................................................
Telephone:...................................................................Cell.................................................
Email or
Fax:.......................................................................................
Payment By Check or Money
order: If you are paying by check,
please send your check or money order along with this Order Form by mail at
above address. $______________enclosed.
For credit card payments fill the Credit
Card Authorization below:
| Item Name |
Item No. |
Cost $ |
Sales Tax
(NY Residents only |
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CREDIT CARD AUTHORIZATION
This form is to be completed and signed by the
cardholder. We do not accept third party charges or corporate cards Amount
$____________
| THE NAME ON THE
CARD MUST MATCH THE NAME IN THE ORDER FORM. |
Credit Card
Numbers |
Date of
Expiration |
CSC
(on back strip of VI, MA, DS or on front
of AX card) |
Amount |
| American
Express |
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$ |
| Discover
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$ |
| Matercard |
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$ |
| Visa |
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$ |
I ________________________________________am a
client of Himalayan International Trading, Inc. DBA Homeandfasionimports.com, I
authorize Himalayan International Trading to charge my credit card the total
amount of $___________ for this transaction for the above mentioned
purchases.
Date: _________________
Cardholder
Signature:___________________________________
Card Holder Name:
__________________________________________
Billing address: Cit y __________________________________
State_____________ Zip__________
Please attach photocopy of credit card (front and
back) and Driver's License. Photo copies must be legible. No exceptions.
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