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CHARGE TO THE ACCOUNT OF    COMMERCE BANK CARD    CREDIT SLIPS

费用记入× ×账户                 商业银行信用卡              贷方传票

QUAN  DESCRIPTION  PRICE  AMOUNT

数量    品名           价格    金额   

QUAN  DESCRIPTION  PRICE  AMOUNT

数量    品名           价格   金额    

………………………………

____________                                           ………………………………

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

………………………………

REASON  FOR  RETURN  SUB 

收益原因         TOTAL小计： 

38337    DATE    SALES TAX  

（编号）  日期     销售税：    

TOTAL总计：

_____________

    I hereby request that the Commerce Bank Card cardholder account imprinted above be credited with the amount shown hereon as Total because of the return of, or adjustments on, the goods and/or services described, and authorize the bank to which this credit slip is delivered to charge my account in my membership agreement in the Commerce Bank Card System.

    在此我要求把本单据上所列的货物和（或）服务总计金额记入票上所印的商业银行信用卡持卡人账户贷方，并授权收单银行根据我的商业银行信用卡体制成员协议规定将其记在我的账上。

MEMBER

AUTHORIZED

SIGNATURE______________    ______________

授权成员签字                                           CUSTOMER'S SIGNATURE

CALD-4                                                顾客签字

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