Formulario Tarjeta de Crédito - in

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Application booking form Credit Card

1.0 Personal

1. Name: Ezequiel

2. Surname: Rosenfeldt

3. Number credit card: 3716902677 72001

4. Credit card expiration: 09/23

5. Amount: 3.561,40 Euros

2.0 Apartme

1. Reference: 122T1CR1E

2. Check-in: 22/12/18

3. Check-out: 5/02/19

The client is obliged to fill the application form including the authorization.

I _Ezequiel Rosenfeldt___________________________________________, authorize Decoflat


S.L., ShBarcelona to make the charge on my credit card with the information I fill in this
application.

SIGNATURE:


Attachments needed:

Passport scanned and credit card scanned on both sides.

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