◆○◆_____________________________________________________________________

CHARGE TO THE ACCOUNT OF    COMMERCE BANK CARD    CREDIT SLIPS

費用記入× ×賬戶                 商業(yè)銀行信用卡              貸方傳票

QUAN  DESCRIPTION  PRICE  AMOUNT

數(shù)量    品名           價格    金額   

QUAN  DESCRIPTION  PRICE  AMOUNT

數(shù)量    品名           價格   金額    

………………………………

____________                                           ………………………………

（注：賬戶名稱）                                       ………………………………

………………………………

REASON  FOR  RETURN  SUB 

收益原因         TOTAL小計： 

38337    DATE    SALES TAX  

（編號）  日期     銷售稅：    

TOTAL總計：

_____________

    I hereby request that the Commerce Bank Card cardholder account imprinted above be credited with the amount shown hereon as Total because of the return of, or adjustments on, the goods and/or services described, and authorize the bank to which this credit slip is delivered to charge my account in my membership agreement in the Commerce Bank Card System.

    在此我要求把本單據(jù)上所列的貨物和（或）服務總計金額記入票上所印的商業(yè)銀行信用卡持卡人賬戶貸方，并授權(quán)收單銀行根據(jù)我的商業(yè)銀行信用卡體制成員協(xié)議規(guī)定將其記在我的賬上。

MEMBER

AUTHORIZED

SIGNATURE______________    ______________

授權(quán)成員簽字                                           CUSTOMER'S SIGNATURE

CALD-4                                                顧客簽字

………………………………………………………………………………………………………