. WA swiss-beluorel RNEO-SAMARINDA-INDONESIA Nama ANNISA.LIRE, Mrs “Tanoga Kedstangan 2 16November.2021 Nome ‘rival Date Pemesan : BUSINESS DEAL Tanggal Keberangkatan 3 18-November-2021 Contact Departure Date Alamat ? UJOH BILANG RT.09 KEL/DESA: Nomor Folio z 446868 Adeoss UJOH BILANG KEC: LONG BAGUN Foto Number Nomor Kamar : 1020, ‘Room Number 7 Harga Kamar 2 Rp. 753.000 zp Room Rete PritNo: 1 UserID: RAHMAN IN IAN Tanggal Transat Keleangan , Debit edt Activity Date Transaction Description Charges Crecits ——— Ta Tests 16-Nov DEPOSIT 58467 = 800,000,00 Room Charge Room # 1020 753.000,00 18-Nov DEPOSIT 58467 ~ 800,000,00 Room Charge Room # 1020 753.000,00 PA meat 19 NOV 2021 TERIMA KASIH Page tot Sato (1600,000,00) SAYA MENYETUJUI KEWAJIBAN SAYA ATAS TAGIHAN INI Batence DAN BERTANGGUNG JAWAB SECARA PRIBADI DAN PENUH DALAM HAL ORANG, PERUSAHAAN ATAU ASOSIASI YANG MENANGANI RESERVAS! NITIOAK MEMBAYAR SEBAGN ATAU SEMUA TAGINAN I AGREE THAT MY LIABILITY FOR THIS BILL IS NOT WAIVED AND AGREE THAT Tanda Tangan MY LIABILITY FOR THIS BILL IN THE EVENT THE INDICATED PERSON, ‘Signature _ COMPANY OR ASSOCIATION FAILS TO PAY FOR ANY PART ON THE FULL MOUNT OF THESE CHARGES. J. Mutawarman 8, Samatinda 75112 Telephone : (62-541) 200 888, Facsimile : (62-541) 201 888 E-mail: samarinda@swiss-bethotel.com Website : www. swiss-belhotel.com DA swiss-betnorel international