PULLMAN RIM OLD TOWN HOTEL

PULLMAN RIM OLD TOWN HOTEL 24 JEKABA STR. LV-1050 RIM LATVIA +371 67815444 AUTHORISATION TO CHARGE MY CREDIT CARD ACCOUNT Room reservation conformation Nr.......... Name (as it appears on card): Card type (please check): Card number: Expiry date: VISA Mastercard / Eurocard Maestro By signing this form, I authorize Hotel Pullman Riga Old Town to charge my credit card account with the following amount: (currency) (amount) for (description of the services purchased; confirmation/invoice number): Date: Place of signing: Signature of cardholder: Completed authori 1371 67815444 Contact person handling my bookings: Please keep a copy of this form for your own records! EFTA00293605