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CHARGE TO THE ACCOUNT OF    COMMERCE BANK CARD    SALES SLIPS

费用记入× ×账户             商业银行信用卡        售货单

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QUANTITY  DESCRIPTION  PRICE  AMOUNT

数量       品名        价格    金额

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_________________                              …………………………………………

（注：账户名称）                                  …………………………………………

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TAKE供货    DEPT．    SUB     

SEND送货    部门      TOTAL小计

36953  SALES CLERK  SALESTAX 

售货员     销售税    

DATE    AUTH CODE   TOTAL   

日期       密押       总计       

    I hereby authorize the Issuer of Commerce Bank Card imprinted above to pay the amount shown as Total hereon upon presentation hereof to Issuer by a bank which is a member of the Commerce Bank Card System. I hereby promise to pay said Issuer the amount shown as Total hereon （together） with other charges due thereon, if any subject to and in accordance with the terms of the cardholder agreement governing the use of Issuer's Commerce Bank Card.

    在此我授权单上所印的商业银行信用卡发卡银行，一旦收到属于商业银行信用卡体系成员银行所提示的售货单，立即按此售货单的总计金额进行支付。我在此允诺按本单据所示的总计金额，连同按照和根据调整商业银行信用卡使用关系的条款规定而产生的其他应付费用一起偿付给上述发卡银行。

CUSTOMER’S SIGNATURE                                    CUSTOMER COPY

顾客签字                                                      此联顾客留存

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