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Credit Card Number

example: 1010101010101010

Name on Card

required. example: John Wick

Expiration Date

2 digits, like 08

4 digits, like 2021

CVC Code

3 digits number in the back

3 digits, like 476

Donate Invoice to "財團法人罕見疾病基金會"

or send invoice to this address:VAT No. / 統一編號 (optional)Bill To / 買受人抬頭 (optional) physical invoice only applicable in Taiwan

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Due to our location, payment will be made with NTD(New Taiwan Dollar) after converting from USD with the latest rate

Subscribed.