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DEPOSIT CONFIRMATION
 

 

Reportar Depósito
Order number

Deposits carried thru within Mexico

My deposit
was held thru banamex in account number 00000000 on the title Unidos en La Prevencion de Adicciones, A.C. so as to request for a tax deductible receipt.
was held thru bancomer in account number 000000 under the tiltle of Unidos en La Prevencion de Adicciones, A.C. so as to request for a tax deductible receipt.
was held thru banamex in account number 0000 000 0000 under the title of Arteregio.com S.A. de C.V so as to request buisness invoice.

Other countries
Shortly

U.S. dlls deposited

Figure expressd in writing

Date of deposit (dd/mm/yyyy)

Please fill in the following form mandatory for working out your tax deductible receipt or buisness invoice.

Name or Title:
I.R.S. AddressDomicilio fiscal:

Address line 1:
Address line 2:
City
State
Country
ZIP Code
Title file number
Contact person
Phone
E-mail
 
Observations:

Thank you for visiting us we will refer to you shortly.

 

 

 

Calles, Eliza

Castillo, Roberto

Calles, Eliza
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