EFTA00313907.pdf

AUTHORIZATION FORM Please fill out and sign the Authorization form in printed letters, attach passport copy, the credit card copy of both sides, and bank confirmation with the stamp that the card belongs to the person signing the agreement, send the whole file to the attention of the Reservation department: rtstn ati mu.. a stanclartliottl.com Date Jut-i }-, 301 Address ci C- AS -r "31 Si Sr. NI `) I I TelAFax E-mail address Topic Crean t_am guarantee I tetchy, I Jr i 2e- ‘1 ?SS The card holderfirst andlast name Authorize the payment of with my credit carc i %o' rAinr'4,44" Pavrneht for: EtAll expenses 0 Pay TV 9 SPA 0 Accommodation incl VAT ❑ Telephone Taxi ❑ Breakfast ❑ Laundry'Dty cleaning El Other expenses During the period of stay sj t_fL>j I r ca0 1,? Arrived date Departure date For MrAMrs. Reservation No Amount Signature Date ,17" t.4 c t ,3 oIF? the c Sincerely, Reservations EFTA00313907