London-hotel-travel.com Credit Card Information Fax Form Authorized by Happy Discount Limited Partnership |
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| Please Print this form, fill out completely and fax
it to the following fax number: Thailand : +662 - 237- 4574 |
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| Fax-in Payment | Transaction Date : | |||||||||
| Personal Particulars | ||||||||||
| Name | :................................................................................................................................. | |||||||||
| Telephone | :................................................................................................................................. | |||||||||
| :................................................................................................................................. | ||||||||||
| Payment Particulars | ||||||||||
| Credit Card Type | Visa Master Amex Diners Club | |||||||||
| Credit Card Number | :................................................................................................................................. | |||||||||
(The last 3 to 4 digit number appearing on the signature panel) |
:................................................................................................................................. | |||||||||
| Card Holder's name | ||||||||||
| Expiry Date (MM/YYYY) | :................................................................................................................................. | |||||||||
| Remarks | :................................................................................................................................. | |||||||||
| :................................................................................................................................. | ||||||||||
| Card Holder's Signature | :................................................................................................................................. | |||||||||
| Booking Particulars | ||||||||||
| Hotel name | :.................................................................................................................................. | |||||||||
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I understand that Happy Discount Limited Partnership will appear on my credit
card statement for this transaction and that should I have any problems
with this order, I can contact Happy Discount Limited Partnership for a prompt resolution by emailing info@hoteldiscovery.net or calling 662-237-4577. |
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