Сredit card authorisation Гостиница «Арт-Отель»

	ГОСТИНИЦА «АРТ-ОТЕЛЬ»
125252, Москва, 3-я Песчаная ул. 2, тел.: [phone], факс: [phone], e-mail: *****@***ru	125252, Moscow, 3rd Peschanaya str., 2, phone: [phone], fax: [phone], e-mail: *****@***ru

DATE ____________________________

CREDIT CARD AUTHORISATION

I,

Mr/Mrs _________________________________________Company___________________________________________

tel/fax _________________________________ address ____________________________________________________

__________________________________________________________________________________________________

CONFIRM, THAT :

The amount of 2500 RUR for Visa Support in a case of no-show or booking cancellation

For guests: _________________________________________________________________________________________

__________________________________________________________________________________________________

During the period from __________________________________till __________________________________________

WILL BE PAID

from my credit card (circle appropriate credit card type):

VISA MASTERCARD

 

AMERICAN EXPRESS DINERS CLUB

number___________________________________________________________________________________________

valid till___________________________________________________________________________________________

signature__________________________________________________________________________________________

Purpose of trip_________________________ Kind of Visa SINGLE

 

MULTIPLE

 

OTHER_________________________