印刷品 信用卡付款表格


 信用卡號碼:                                                  

 有效日期 (月月/年年):

                                                
 持卡人姓名:                                                    簽名:                                                 
 信用卡類別: Visa/MasterCard/Amex (請圈選信用卡類別)  
 金額:                                                    請款單號碼: