TOKUGAWA-ART SECURE ORDER FORM
Please read carefully HOW TO ORDER BEFORE YOU PLACE ORDER(S).
This is a SECURE ORDER FORM through SSL server system.Please entirely fulfill  this form then simply clicking ORDERor print the SECURE ORDER FORM and fax it to us at "81-52-935-2488".Upon obtaining payment, your order will be placed and proceeding shipping.
We reserve our right to request credit card holder to submit us photo copy of Credit Card or the other Personal Identifications for verification.

Currency/Products Information
CURRENCY(CREDIT CARD IS PROCESS IN JPYEN):
Card charges appears on your Card Statement is to be processed into local currency in your country
JAPANESE Yen USD Euro
I WISH I PLACE AN ORDER FOR THE ITEM(S) OF:
iTEM NO. COST(AS QUOTED)
DESCRIPTION
ITEM NO. COST(AS QUOTED)
DESCRIPTION
ITEM NO. COST(AS QUOTED)
DESCRIPTION
SHIPPING FEE:(AS QUOTED)
TOTAL BILLING AMOUNT:(COST PLUS SHIPPING)
PAYMENT METHOD:
IN CASE OF CREDIT CARD PAYMENT,PLEASE FULFILL THE FOLLOWING:
Card charges appears on your Card Statement is to be processed into local currency in your country
KIND OF CREDIT CARD:
CREDIT CARD HOLDER'S NAME:(AS APPEARS ON YOUR CREDIT CARD)
CREDIT CARD NUMBER:(AS APPEARS ON YOUR CREDIT CARD)
CARD EXPIRERY DATE:(MONTH/YEAR) such as 08/17
CARD VERIFICATION NUMBER (last 3 or 4 digits that appears in your credit card of your signature area):
In case you don't fill the Card Verification Number above, the payment verification might not be processed smoothly
Billing information
(In case payment is by Credit Card, the Billing address should meet with the one of your credit card)
Name

Address

CityState/ProvinceZip
Country
Telephone Fax E-mail
Shipping information(In case payment is by Credit Card, we only can ship to the Billing address)
Ship to Billing name and address Ship to the following name and address(Fullfill followings)
Shipping Name

Shipping Address

CityState/ProvinceZip
Country
Telephone Fax
PLEASE ADD ANY ADDITIONAL COMMENTS OR REQUEST:

PLEASE MAKE SURE THE ABOVE AND CLICK ONCE FOR SENDING THIS FORM OUT, THANK YOU.

Confirmation before transmission