CREDIT CARD AUTHORIZATION FORM

The Margo Hotel Depok is authorized to bill and process, with signature, my:
Visa Master BCA Card
Card Number :
Expiration Date :
Amount :
Card Holder Name :
*Please send copy (front & back) of the credit card and the identity card.
For the following charge:
□ Room Accommodation
□ Incidental charges
□ All charges, including shops
□ Other :
Incurred by :
Name of Guest :
Date of Stay :
Address where Credit Card Statement is sent:
Address :
City : State :
Zip Code : Country :
Phone Number : Fax Number :
Mobile Number :
Date:
Card member’s Signature:

*PLEASE SEND THE COPY/SCAN OF YOUR CREDIT FRONT & BACK SIDE AND THE IDENTITY CARD.
We are looking forward to welcoming you at The Margo Hotel Depok. Should you requires any further assistance, please do not hesitate to
contact us.