tgarreseet — PRODUCT ORDER FORM Se Unit 5.02, 5th. Floor Care Toner Distributor Services Phone (603) 7491 8898 ge Widalan Pessaran Barat, pegs organ (608) 7493 8812 TocETWER BULDNNGPCDPLE” 46050 Petaling Jay, Selangor Darul Ehsan, ara mesma, NOSTEREA Malaysia Business hours Mon-Fri: 12 noon to 8:30 pm, Sat: 12 noon to 7:00 pm ithe sats00 ee en Sundays and Pubic Holidays Closed ORDER INFORMATION Date KHOR TZE PING 6TAOIAS Distributors Neme/Company Name = : Distributor OF seanraare Cistomers Name ~ (5 tc) Ud eeeeSeUeEEEAEEE ciety Home Phone Office Fone Hand Phone Fax Number Shipping Address (Your products will be lipped to this address) PRODUCT ORDER INFORMATION Them Code Product Name ay & Wholesale | Suggested Reta Tal + Alife is required to collec sales taxon all orders in some countries som | + Distributor certifies when placing this order that they have soldat least seventy percent (70%) saree ofall products previously purchased. OROER TO Please tick either ONE of the following: | pick up my producs Pease ship the products to me as per the shipping address above Mamta” ce fe cece Lather Courier Service Charges: For Shipment within Peninsular Malaysia Please tick either ONE of the following L) Nationwide Courier Service - Delivery is 3 working days at 750 forthe fat kor part threo for spment with Feiner | Geyer Nationwide Courier Service Malai: eve addonl teeter or pan erat atrasca” | elu working dy at M250 forever th or ] skynet courier Service - beiveryis5 working days ot RMT 50 volumetric weight (dimensional weight), whichever is higher. {or every 3kg or part thereof for shipment within Peninsular Malaysia, For Shipment to East Malaysia Nationwide Courier Service understand that products not picked-up within 14 days of the above mentioned date will be shipped out to my address as stated in your records and | will be charged accordingly. Signature __Date. PAYMENT INFORMATION (Payment apoies to al products and services selected above) can ese Vin Gaps io Company Nayak Acount ns EH o Qo o Ci presen Coarse tsriark Arne te 5 Geatra _—_30igR CW Naber Eapiy Date ___ Name on Card and Slgnature (acy asf appears on Gd)