Quotation / Purchase Order Form

Quotation / Purchase Order Form

Inquiry □ Quotation □ Purchase Order

Date : / /

l  Please complete this form and send us by e-mail () or fax (+81-3-5684-6297).

l  Product prices on this catalog and our website do not include shipping and handling charges, VAT, import tariffs and service charges, etc.

Submit this form to :

Export Deperpment, Funakoshi Co., Ltd

E-mail :

Fax : +81-3-5684-6297

Tel : +81-3-5684-6296

Payment method

□ Credit Card

□ Visa □ Master □ AMEX □ Diners Club □ JCB

□ Bank transfer

□ Check

Quotation inquiry form for US Dollar

Item No. / Cat. No. / Description / Quantity / Each price / Total
(Each price × Quantity)
1
2
3
4
5
Subtotal
Shipping and Handling
Total price

※Above price does not include VAT, import tariffs and service charges etc.

※In case of the credit card settlement, the exchange rate on the date of the credit card payment applies.

Customer information

■Billing Address

Name
Title
Institution / Commercial Name
Address
Country / Zip code
Phone / FAX
E-Mail

■Shipping Address (if different from above billing address)

Name
Title
Institution / Commercial Name
Address
Country / Zip code
Phone / FAX
E-Mail

For further information, please contact us.

Funakoshi Co., Ltd.

9-7 Hongo 2-Chome, Bunkyo-ku, Tokyo, Japan, 113-0033

Export Department

E-mail :

Fax : +81-3-5684-6297

Tel : +81-3-5684-6296

We shall take the utmost care in preventing the disclosure, loss or damage of your personal information according to our personal information protection guidelines. For further information on the personal information protection guidelines, please visit our web site: http://www.funakoshi.co.jp/export/