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Resort Address: Beachfront, Station 2, Boracay Island, Aklan, Philippines Tel.No.

: +63 36 288 3444; 288 4999 Email: reservation@boracaymandarin.com Manila Sales Office: c/o Unit 36-G, 36th Floor, Pearl of the Orient Tower Condominium Roxas Boulevard corner Padre Faura Street, Ermita, Manila, Philippines Telephone: +63 2 5671672 / +63 2 524 4759/ +63 567 1750 Fax No.: +63 2 567 1673 Email: info@boracaymandarin.com Website: www.boracaymandarin.com

CREDIT CARD AUTHORIZATION FORM


(Date)______________________
Dear Valued Guest:
Please return this credit card authorization form with ALL the required information for the settlement of a minimum of 50% of the total billing as stated in the statement of account issued to you. Please type or write down legibly the required information in CAPITAL LETTERS. Kindly fax completed form ON OR BEFORE the set OPTION DATE FOR PAYMENT to (632) 567 1673 to finalize and guarantee your booking. For your protection, a copy of the front and back sides of your credit card, and a valid identification ID with picture (such as drivers license, social security card) are required by the authorizing bank for the completion of the transaction. Kindly note that payment for the booking will not be processed if there are incomplete details and if the required documents are not submitted together with this form.

Name of Bank / Card company (i.e. Citibank) Name of Cardholder (Kindly encircle the credit card type) Visa / MasterCard / JCB / AMEX / BPI Card Number: Expiry Date (mo/date/yr):
Last 3 digits at the back of card:

Amount to be Charged: Complete Billing Address: Fax No: Tour Dates: Check-in: Check-out:
I understand that all credit card surcharges apart from the total amount billed will be charged to my account. I also understand that any outstanding or unpaid fees I have incurred at the resort during my stay will be automatically charged to the above-stated credit card.

_____________________________________
Signature over Printed Name of Cardholder

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