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HOTEL RESERVATION
FIRST NAME :
LAST NAME :
ARRIVAL DATE :
DEPARTURE DATE :
ROOM TYPE : HILTO STANDARD / EXECUTIVE ROOM / STUDIO
GROUP NAME : FNC GROUP
AIRPORT PICK : YES/ NO FLIGHT NO : ARR TIME :
FNC GROUP 14TH INTERNATIONAL FREIGHT CONFERNECE
CREDIT CARD PAYMENT AUTHORISATION FORM
Fax Completed form to: Director Finance Hilton Colombo Attn: Alexis Jayatilake
Fax numbers: 0094112325587 / 0094112492193
The Hilton Colombo is hereby authorised to charge to the referenced Credit Card number the services shown. This authorization is valid only for the services declared. Incomplete requests may be rejected. You further acknowledge that if “all charge” has been selected, then all guest/group related charges (less deposit) will be charged to the below card number at the time of check out or event conclusion.
Guets/Event Information:
Guest Name: ______
Check-in/Event start date: ______Check out end date: ______
Name of Person /Group making reservation: ______Phone ______
Card Information: Visa/MasterCard American Express JCB Diners Club
Card # : ______CVV______Expiration date______
Card Holder Name as appears on Credit Card:______
Card Holder Billing address: ______City ______
State ______Post Code ______Country ______
Daytime/Business Telephone: ______Evening Telephone: ______
CC issuing bank name: ______Bank phone no.______(from back of CC if available)
I agree to cover the following categories of charges:
Room & Tax only Food & Beverage All charges Recreation
Group Deposit Invoice/statement name and number ______
Other______
I agree to cover the above categories of charges up to a maximum amount of:
Authorized amount: US$ ______
Note: Charges for Room & Tax, group deposits, or direct bill account payments will be charged to your credit card immediately. Any incidentals charges circled above will be charged at the time of check out.
Amount to be immediately charged to credit card for room & taxes or deposit:
Authorized amount US$/ (LKR)______
Direct bill account payments only: Name on invoice/statement ______
Full invoice address ______Auth. amount US$/ (LKR)______
Credit card holder signature: ______Date: ______
Hilton Colombo,
2, Sir Chittampalam A Gardiner Mawatha,
P.O. Box 1000, Colombo, Sri Lanka.
T: (+94) 11 2544-644/2492-492 F: (+94) 11 2544-657/8
E-mail:
HRW Toll Free: 01 430-800 MTF: 6 8495019
Confidential