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Ayla (HK) Ltd. 

CREDIT CARD AUTHORIZATION FORM

Ayla HK Ltd

Suite 301, Kam On Building

176 A Queens Road Central

Central- Hong Kong

Tel/ Fax No.:+86-579-85206228
e-mail: ayla@netvigator.com  Homepage:www.aylaonline.com

Date:   _______________________________________

Customer Name: ______________________________
E-mail Address:_______________________________
Phone #: _____________________________________

Invoice no. #:________________________________

Credit Card Type:

  • Master Card
  • Visa

Credit Card #:                        __________________________________________________________________

Expiration Date:          ___________/_______/__________   CVS#:___________________________________

Name On Card:            _______________________________________________________________________

Credit Card Billing Address:
 
____________________________________________________________________________________

City: __________________________ State________________ Zip _____________________________

 

Shipping Address: ___________________________________________________________________

____________________________________________________________________________________

 

City: __________________________ State________________ Zip _____________________________

 

The Card Was Authorized To Be Charged: $______________________________

 

X_______________________________________
                                    Signature                               

Please fax back to FAX #+86-579-8520 6228, or Scan and e-mail to: ayla@netvigator.com
By signing this you are giving Ayla (HK) Ltd, authorization to charge to your Visa, or MasterCard for above invoice number.    We look forward to a long and profitable relationship.

Ayla HK Ltd

Suite 301, Kam On Building

176 A Queens Road Central

Central- Hong Kong

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