CREDIT CARD AUTHORIZATION FORM

Date: / /

In lieu of my credit card im rint I! "ere#y aut"ori$e M/% Golden Tulip Grand View Resort, Goa to c"ar&e my credit card for ayment of Hotel 'ill% a% follo(: Credit Card No: Name of t"e Card Holder Card I%%uin& 'an* : +i%a / Ma%ter / Ame) / Ot"er% E) iry Date:

Communication Addre%%: Nationality: E Mail ID : Food , 'e-era&e% : Tra-el De%* 'an0uet% : : Mo#ile No: To#acco : / a Ti % : :

Room C"ar&e% : .aundry :

'u%ine%% Center: Ot"er% : 1ue%t Name: C"ec* In :

C"ec* Out:

'y %i&nin& #elo(! I ac*no(led&e c"ar&e% de%cri#ed "ereon! ayment in full to #e made ("en #illed or in e)tended ayment% in accordance (it" t"e %tandard olicy of t"e com any i%%uin& t"e credit card2

Card Holder Signature

Place

Note: Please attach copy of valid Passport, Voter ! card or driver"s license acco#panied $y the front and $ac% copy of your credit card for this to $e considered a valid authori&ation for#' Golden Tulip Grand View Resort ()* +,G)-G* . ()* /,G)-G0, /a#on Vaddo, Candoli# /arde&, Goa-12(*)* Ph- 23(0-012*322 4#ail- re%er-ation%3&oldentuli &oa2com