[Omakase-Factory] FAX +81-55-962-1768　　　　　Fax Order Sheet For A4 size
Item* Quantity* Price* The carriage is actual expenses.
There is no commission needing.
It is possible to send it by EMS safely and surely.
It might be dutiable in the locale.
After the order, it produces it.
Therefore, the weight of the product cannot be calculated beforehand.
Please think own sending from Japan.
We will report the total amount with E-mail or FAX. Consumption tax (5%) of Japan is levied.
[An orderer]*　　[*A required item]
NAME*

ZIP CODE*
ADDRESS*


E-mail*
TEL*
FAX*
[An address of the delivery future]←It enters when differing from the person who orders.
NAME

ZIP CODE
ADDRESS


TEL
[PAYMENT]*
[Credit card company]
ＶＩＳＡ ＭＡＳＴＥＲ ＪＣＢ ＡＭＥＸ ＤＩＮＥＲＳ
[Credit card number] ---
[Term of validity] /(mm/yy)
[Name on the card]
[Reports from customer]