開戶銀行:______________開戶銀行:______________
帳號:__________________帳號:__________________
地址:__________________地址:__________________
傳真:__________________傳真:__________________
電話:__________________電話:__________________
銷貨方(甲方)簽章:________購貨方(乙方)簽章:______
________年____月____日