CARDHOLDER COPY

wpid-bank-copy.jpg

BANK OF CHINA
MERCHANT
TERMINAL ID.
MERCHANT NO.
CARD TYPE NUMBER:
TRANS. TYPE:
EXP. DATE
BATCH NO.
TRACE NO
DATE / TIME
REF. NO.
AUTH. CODE

I ACKNOWLEDGE SATISFACTORY RECEIPT OF RELATIVE GOODS/SERVICES.

CARDHOLDER SIGNATURE

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