Pearl River

Pearl River Mart - Please download form from the following link.

loanagreement.doc

Merchandise Loan Agreement Form
Fax or Email this agreement back to: (212) 925-0206 wilkiewong@pearlriver.com
Attn: Wilkie Wong or Mrs. Chen
To contact, please call Tel: (212)-925-2140

Name / Title of Borrower:
Magazine name / Publisher:
Address:

Tel:
Fax:
Email:

Item #	Description / Color / Size	Qty.	Retail price







Credit Card Info	(Upon request only, otherwise leave it blank)
Card Holder’s Name:
Card Number:
Exp. Date:
ID code:

If more space is needed, please attach new sheet.

Pick up Date:
Return Date:	(maximum 10 business days from pick up)

By signing below, I guarantee to return all above merchandise in its original condition by the return date; and fully understand that if any merchandise is lost or damaged, I will be responsible to pay the retail price to Pearl River Mart.

Signature:
Date:

Once the merchandise is ready, we will assign you with a pick up number.

Pick up location: Pearl River Mart (477 Broadway, NY 10013)
Pick up days & hours: Mon. to Friday / 11 am to 6 pm.
Ask for Dada or Barry.