evowera planck order form

evowera planck O1

Adaptive Sonic Electric Toothbrush
Your Name*

First NameLast Name
Phone No*
Your Email
example@example.com

My Products

planck O1 Black Color Product Image

planck O1 Black Color

1,299HKD Quantity
Item subtotal:0.00HKD

planck O1 Lyra Ivory color Product Image

planck O1 Lyra Ivory color

1,299HKD Quantity
Item subtotal:0.00HKD

Enter coupon

Total

0.00HKD

Requested Payment ( HKD )*
Billing Address

Room / Floor / Building Name

Street Address

DistrictHK Island / Kowloon / New Territories / Macau

District
Is shipping address same as billing address?

YesNo
Shipping Address

Room / Floor / Building Name

Street Address

DistrictHK Island/ Kowloon / New Territories / Macau

Postal / Zip Code
Send Gift?

YesNo
Recipient's Full Name

First NameLast Name
Gift Message
Special Instructions
Your Ref No
Payment Method

By Fast Payment System :

FPS ID : 162288708
FPS Confirmation No :
By Bank Deposit :

Bank Name : INDUSTRIAL AND COMMERCIAL BANK OF CHINA (ASIA) LIMITED

Bank Address : 33/F ICBC TOWER, 3 GARDEN ROAD, CENTRAL & WESTERN DISTRICT, HONG KONG

SWIFT : UBHKHKHH

BANK CODE : 072 A/C : 886 502002791

ACCOUNT NAME : BEST LEAPS TRADING CO. LIMITED
Take photo of your bank in slip
If there is any queries, please contact Mr. Ben Ho at 36752712 or Mobile 95326788

or email to info@shriroimaging.com.

We will contact you within 24 hours after receiving your order.

Thank you for your business.
Shriroimaging Email :
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