(To be used by Hotel Guest/External Guest). This is to authorize the Centro
Rotana, Yas Island to bill the hotel invoice of: Guest Name : ANDREA
NISSOLINO.
03rd Party Credit Card Billing Authorization Form (To be used by Hotel Guest/External Guest) This is to authorize the Centro Rotana, Yas Island to bill the hotel invoice of: Guest Name : ANDREA NISSOLINO Arrival Date : 16 OCTOBER Departure Date : 18 OCTOBER Room Type : CLASSIC ROOM – REF 62720323 No of Rooms : 1 For the following charges to: X Room only □ Room & Meals □ Banquet Charges □ My Credit Card: □ Amex
X Visa
□ □ □ □ Diners
Room & Breakfast Full Bills others □ Master
□ JCB
Credit Card Holder Name: ORIETTA DEL NERO Credit Card Number 4830 5400 0030 7747 Expiration Date 10/14 Billing Address of the credit card Address VIA DELLA PURIFICAZIONE 15 P.O. Box 00187 – ROMA - ITALY Tel. +39 06 4746541 Fax +39 06 4880310 Mobile +39 3355337841 Email
[email protected]
AUTHORIZED BY: ORIETTA DEL NERO Card holder Name
DIRECTOR Position
Signature (Cardholder signature is a must)
HOTEL APPROVAL: ……………………………………………………………………………………………………… Name Position Signature
Please send us both sides of the credit card scan copy & passport copy or valid ID of the card holder along with this form. (Completed form should submit to the hotel three days prior to arrival)
