傳真訂購單Fax Order Form
會員號碼
Membership Number
Membership Number
日期
Date
會員姓名
Name
Name
統一編號
TAX No
聯絡電話
TEL
TEL
傳真號碼
FAX
收貨人
Consignee
Consignee
送貨地址
Delivery Address
Delivery Address
配送日期
Delivery Date
Delivery Date
取貨方式
Pick-up Method
Pick-up Method
商品編號
Item No.
Item No.
商品名稱
Description
Description
數量
Qty.
Qty.
單價
Unit Price
Unit Price
總 計 / TOTAL
付款方式
Method of Payment
Method of Payment
(1) 以信用卡方式付款 Pay By Credit Card
信用卡卡號
Credit Card No.
Credit Card No.
有效期限
Ex. Date
Ex. Date
消費金額
Amount N.T. Dollar
Amount N.T. Dollar
持卡人姓名
Card Holder's Name
Card Holder's Name
持卡人簽名
Authorized Signature
Authorized Signature
*請勿使用email傳送信用卡資料，請以傳真方式提供。
Do not submit credit card detail via email, please provide by fax
*信用卡持卡人須與Costco會員卡持卡人為同一人The credit card holder must be the same person as the Costco membership cardholder
*持卡人同意依照信用卡使用規定，一經使用或訂購物品，均應按照所指示之全部金額付款於發卡銀行。
The issuer of the card identified on this form is authorized to pay the amount shown as total upon proper presentation.
I promise to pay such total (together with any other charges due thereon) subject to and in accordance with the agreement governing the use of such card.
(2) 付現或電匯 / Via Cash or Via Electronic Transfer
新北市汐止店商業配送中心
銀行：兆豐國際商業銀行 南港分行（銀行代號：017）
抬頭：好市多股份有限公司 汐止分公司
帳號：07409006780
匯款完請將憑證傳真至 COSTCO (02) 2641-0877
Shihchih Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Nan Gang Branch
Name of Account：Costco Shihchih Branch
Account No.：07409006780
After remitting, please fax your remittance receipt to (02) 2641-0877
銀行：兆豐國際商業銀行 南港分行（銀行代號：017）
抬頭：好市多股份有限公司 汐止分公司
帳號：07409006780
匯款完請將憑證傳真至 COSTCO (02) 2641-0877
Shihchih Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Nan Gang Branch
Name of Account：Costco Shihchih Branch
Account No.：07409006780
After remitting, please fax your remittance receipt to (02) 2641-0877
桃園店商業配送中心
兆豐國際商業銀行 南崁分行（銀行代號 : 017）
抬頭：好市多股份有限公司 桃園分公司
帳號：08009010788 匯款完請先將憑證傳真至 COSTCO (03) 270-6881
Taoyuan Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd. Nan Kan Branch
Name of Account：Costco Taoyuan Branch
Account No. : 08009010788
After remitting, please fax your remittance receipt to (03) 270-6881
兆豐國際商業銀行 南崁分行（銀行代號 : 017）
抬頭：好市多股份有限公司 桃園分公司
帳號：08009010788 匯款完請先將憑證傳真至 COSTCO (03) 270-6881
Taoyuan Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd. Nan Kan Branch
Name of Account：Costco Taoyuan Branch
Account No. : 08009010788
After remitting, please fax your remittance receipt to (03) 270-6881
新竹店商業配送中心
銀行：兆豐國際商業銀行 中台中分行（銀行代號 : 017）
抬頭：好市多股份有限公司 新竹分公司
帳號：20809022298
匯款完請將憑證傳真至 COSTCO (03) 563-1212
Hsinchu Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Chupei Branch
Name of Account：Costco Hsinchu Branch
Account No.：20809022298
After remitting, please fax your remittance receipt to (03) 563-1212
銀行：兆豐國際商業銀行 中台中分行（銀行代號 : 017）
抬頭：好市多股份有限公司 新竹分公司
帳號：20809022298
匯款完請將憑證傳真至 COSTCO (03) 563-1212
Hsinchu Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Chupei Branch
Name of Account：Costco Hsinchu Branch
Account No.：20809022298
After remitting, please fax your remittance receipt to (03) 563-1212
台中店商業配送中心
銀行：兆豐國際商業銀行 中台中分行（銀行代號 : 017）
抬頭：好市多股份有限公司 台中分公司
帳號：20409804796
匯款完請將憑證傳真至 COSTCO (04) 3704-2799
Taichung Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Central Taichung branch
Name of Account：Costco Taichung Branch
Account No.：20409804796
After remitting, please fax your remittance receipt to (04) 3704-2799
銀行：兆豐國際商業銀行 中台中分行（銀行代號 : 017）
抬頭：好市多股份有限公司 台中分公司
帳號：20409804796
匯款完請將憑證傳真至 COSTCO (04) 3704-2799
Taichung Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Central Taichung branch
Name of Account：Costco Taichung Branch
Account No.：20409804796
After remitting, please fax your remittance receipt to (04) 3704-2799
嘉義店商業配送中心
銀行：兆豐國際商業銀行 嘉義分行（銀行代號 : 017）
抬頭：好市多股份有限公司
帳號：02201037789
匯款完請將憑證傳真至 COSTCO (05) 320-0670
Chiayi Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Chiayi Metropolitan Branch
Name of Account：Costco President Taiwan Inc.
Account No.：02201037789
After remitting, please fax your remittance receipt to (05) 320-0670
銀行：兆豐國際商業銀行 嘉義分行（銀行代號 : 017）
抬頭：好市多股份有限公司
帳號：02201037789
匯款完請將憑證傳真至 COSTCO (05) 320-0670
Chiayi Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Chiayi Metropolitan Branch
Name of Account：Costco President Taiwan Inc.
Account No.：02201037789
After remitting, please fax your remittance receipt to (05) 320-0670
台南店商業配送中心
銀行：兆豐國際商業銀行 府城分行（銀行代號 : 017）
抬頭：好市多股份有限公司 台南分公司
帳號：00609123788
匯款完請將憑證傳真至 COSTCO (06) 700-0566
Tainan Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd. Fucheng Branch
Name of Account：Costco Tainan Branch
Account No.：00609123788
After remitting, please fax your remittance receipt to (06) 700-0566
銀行：兆豐國際商業銀行 府城分行（銀行代號 : 017）
抬頭：好市多股份有限公司 台南分公司
帳號：00609123788
匯款完請將憑證傳真至 COSTCO (06) 700-0566
Tainan Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd. Fucheng Branch
Name of Account：Costco Tainan Branch
Account No.：00609123788
After remitting, please fax your remittance receipt to (06) 700-0566
高雄店商業配送中心
銀行：兆豐國際商業銀行 港都分行（銀行代號 : 017）
抬頭：好市多股份有限公司
帳號：00209011308
匯款完請將憑證傳真至 COSTCO (07) 536-3608
Kaohsiung Warehous
Name of Bank：Mega International
Commercial Bank Co., Ltd., Kaohsiung Metropolitan Branch
Name of Account：Costco President Taiwan Inc.
Account No.：00209011308
After remitting, please fax your remittance receipt to (07) 536-3608
銀行：兆豐國際商業銀行 港都分行（銀行代號 : 017）
抬頭：好市多股份有限公司
帳號：00209011308
匯款完請將憑證傳真至 COSTCO (07) 536-3608
Kaohsiung Warehous
Name of Bank：Mega International
Commercial Bank Co., Ltd., Kaohsiung Metropolitan Branch
Name of Account：Costco President Taiwan Inc.
Account No.：00209011308
After remitting, please fax your remittance receipt to (07) 536-3608
備註 / NOTE
- 型錄上所有品項資訊及商品圖片僅供參考，實際品項、包裝與數量以賣場為準。The pictures are for reference only, please contact warehouse for more details.
- 上列報價為會員價且已含5%營業稅。All prices above are with 5% tax included.
- 本報價單價錢如有變動依賣場實際價格為準。Prices and products are subject to change. For current product availability and price confirmation please Contact Warehouse.
** 售價以匯款日當天價格為準。 ** Sell prices are based on warehouse price on the date of remittance. - 貨物數量經買賣雙方清點簽收後，Costco 概不負責。All purchase quantities should be counted at time of delivery. Costco will not be responsible for any discrepancies once the purchase has been received.
- 本公司對於您所購買之商品皆提供商品滿意保證，若您有任何不滿意，30天內* 請將完整包裝之商品 (含商品保證書)攜回至賣場退貨櫃檯，進行退貨手續。 (退貨時，請攜帶收據、發票與公司發票章；若您是以信用卡付款，同時亦請付款人持信用卡一同前往。) *30天內，意指從您收到貨品起算30天。
Costco provides members 100% Satisfaction Guarantee： We guarantee your satisfaction on every product we sell with a full refund. To return a product purchased through the Costco Business Delivery, please bring the product in its original packaging (including its warranty letter) to the in-store Return Exchange Counter within 30 days. (Please remember to bring your receipt, " invoice and tax no. chop. If the purchase was made with a credit card, the credit card holder should bring the card with " him/her when refunding.) *Within 30 days will be counted from the date you receive the merchandise you ordered.
Costco 承辦人簽章
ostco Representative Signature
ostco Representative Signature