|
|
        |
Order
Form Please print the order form, complete the order form and fax at 212-564-2188 or email. Himalayan lnternational Trading Himalayan International 126 Madison Ave., 2nd Floor New York, NY 10016 (212) 564-5164 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:
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 $____________
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. |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Himalayan International Trading 205 Mineola Blvd. Suite 1B Mineola, NY 11501 (516) 739-4660 Fax: 516-739-4663 Email: homefashionimports@att.net |