2014美濃白玉蘿蔔股東會 - 匯款資料單(第二階段)

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選項 1

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姓名 *

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身分證字號含英文字母前五碼 *

供與第一階段資料核對用例A1234

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匯款總額 *

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匯款日期 *

西元年/月/日例2013/10/22

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您的匯款帳號末五碼阿拉伯數字 *

臨櫃現金請填寫"現金匯款"

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對帳 *

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聯絡電話 *

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