ORDER FORM

 Mail to:
Phone: 212.587.7021   KORIN Japanese Trading corp.
Fax: 212.587.7027   57 Warren Street
E-mail: sales@korin.com   New York NY 10007

Please fill out your order completely and then submit it to Korin by fax, or e-mail. Retain a copy for your records.

SOLD TO SHIP TO
Company Company
Name Name
Address *Address
City City
State Zip State Zip
Telephone Fax Telephone Fax
E -Mail E -Mail

* We cannot ship items to P.O. Boxes.

METHOD OF PAYMENT
 Check/Money Order  Visa  Master Card  Amex  Discover
Credit Card #
Exp. Date (month/year) Security Code
Cardholder’s Name
** Billing Address if Different
City State Zip
Signature
Date        

** Must be the same address that you receive your credit card statement. Incorrect information may cause delay.



ITEMS # DESCRIPTION QUANTITY PRICE PER ITEM TOTAL
         
         
         
         
         
MERCHANDISE SUB-TOTAL  
SHIPPING CHARGES 10% (Minimum $10)  
IF STATE IS NY or NJ, ADD SALES TAX*  
GRAND TOTAL  

  All payments in U.S. dollars only.
  Personal checks accepted. Please allow 3 to 5 business days for clearance of the checks.
  Call for expedited shipping charges and International freight.