Please
print thiscredit card authorization
form and send to :
+62-361-771274
IMPORTANT
: Your credit card will be used as a guarantee ONLY
and will be charge if there is any cancellation within certain
period of cancellation policy. All payment will be collected
upon arrival in Bali except for reservation beyond Bali
CREDIT CARD AUTHORIZATION FORM
To secure my reservation I hereby to authorize TUR BALI
to charge my credit card as specified hereunder.
Being Charge for Accommodation / Tours, etc :
Tour Information :
Booking Reference:
Tour Name:
No. of Children (s):
Ages of children:
Check In
Check Out
Special Requests:
Additional Requirements:
Airport Transfer:
I wish to confirm and guarantee
my reservation by :
Credit
Card Information : Please be assured that we will not debit your credit
card until you have agreed on the accommodation and until
your reservation is confirmed.
*Type
of Credit Card :
VISAMASTER CARDAMEX
*Credit
Card Number :
*Expiry
Date (MM/YY) :
/
(As shown on card)
*3
Digit Code After Card # on Back of Card :
(as shown on the signature
panel on your card)
*Name
as it appears on card :
First Name
Middle Name
Last Name
(As shown on card)
*Card
Holder Address :
*City
:
*State
or Province :
*Postal
Code :
*Country
:
Phone :
*Email
Address :
*Signature
:
I understand that credit
card payment are subject to 3% added bank service
charge and calculated on the bank exchange rates the day
processing. Differentiation in personal statement balances
can occur and are due to the fluctuation with the Indonesian
Rupiah (IDR) and bank processing time. We are not held responsible
to these differences. By sending this Credit Card Authorization
Form I agree with turbali.com Terms & Conditions
