Quotation / Purchase Order Form

Inquiry Quotation

Purchase Order
Date :

Please complete this form and send us by e-mail (export@funakoshi.co.jp) or fax (+81-3-56846297).
Product prices on this catalog and our website do not include shipping and handling charges,
VAT, import tariffs and service charges, etc.
Submit this form to :
Export Deperpment, Funakoshi Co., Ltd
E-mail : export@funakoshi.co.jp
Fax : +81-3-5684-6297
Tel : +81-3-5684-6296

Payment method

Credit Card
Visa Master AMEX Diners Club JCB
Bank transfer
Check

Quotation inquiry form for US Dollar

Item
No.

Cat. No.

Description

Quantity

Each price

Total

(Each price Quantity)

1
2
3
4
5
Subtotal
Shipping and Handling
Total price
Above price does not include VAT, import tariffs and service charges etc.
In case of the credit card settlement, the exchange rate on the date of the credit card payment
applies.

Customer information
Billing Address
Name
Title
Institution /
Commercial Name
Address
Country

Zip code

Phone

FAX

E-Mail

Shipping Address (if different from above billing address)

Name
Title
Institution /
Commercial Name
Address
Country

Zip code

Phone

FAX

E-Mail
For further information, please contact us.
Funakoshi Co., Ltd.
9-7 Hongo 2-Chome, Bunkyo-ku, Tokyo, Japan, 113-0033
Export Department
E-mail : export@funakoshi.co.jp
Fax : +81-3-5684-6297
Tel : +81-3-5684-6296
We shall take the utmost care in preventing the disclosure, loss or damage of your personal
information according to our personal information protection guidelines. For further information on
the personal information protection guidelines, please visit our web site:
http://www.funakoshi.co.jp/export/