China Pearl Import
CPI Center
10220 Norris Ave.
Pacoima, CA 91331
Phone:  (818) 249-9888 Fax:  (818) 249-4777
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CREDIT CARD AUTHORIZATION
Please fill out form, print and fax to (818) 249-4777

Invoice # / Sales Order#:

Master Card  Visa

Amount Authorizing:

  Amount:
$

  Initial:

Company Name:
Credit Card Holder:
Credit Card Number:
Expiration Date:
Phone Number:      Fax Number:
Card Holder Signature:

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Statement Billing Address:
(office use)
Authorization Number:
 

www.chinapearl-usa.com