AUTHORIZATION FORM Please fill out and sign the Authorization form in printed letters, attach passport copy, the credit card copy of both sides, and bank confirmation with the stamp that the card belongs to the person signing the agreement, send the whole file to the attention of the Reservation department: rthotel.com or: Date “VuLYy + © } Address ; I } Tel. \Fax E-mail address Topic Hereby, |__ Ei FREY Care Ne Pad The card holder first and last name Authorize the payment of with my credit care Payment for: CA All expenses C) Pay TV C) SPA {_] Accommodation incl VAT ] Telephone L_} Taxi [_] Breakfast [Jt aundry\Dry cleaning CJ Other expenses _ — . > ~, ' IO During the period of stay <JLPLY 7 ~a Old LAL iis Arrival date Departure dat me ie po =" Reservation No Amount . . 1 os 3° ‘ Signature aE K Date. Ji“t-y the card folder y — Sincerely, Reservations EFTA00313907