REGISTRATION FORM

*** CROWN HOTEL REGISTRATION FORM

JL. RE. MARTADINATA NO. 45 TASIKMALAYA ROOM RATE
: *** CROWN HOTEL 0000485
PHONE
JL. (0265) 332282NO.
RE. MARTADINATA FAX45(0265) 333967
TASIKMALAYA ROOMARRIVAL DATE
RATE
:ACCOUNT NUMBER 0000589
ROOM ROOM ARRIVAL TIME
PHONE (0265) 332282 FAX TYPE (0265) 333967
NUMBER ARRIVAL DATE
:
ACCOUNT
DAILY RATE NUMBER ROOM ROOM
NO OF _________
ADVANCE ARRIVAL TIME
CHECK OUT
TYPE
GUEST NUMBER
DEPOSIT TIME 12 PM
DAILY RATE NO OF _________
ADVANCE CHECK OUT
DATANG TANGGAL GUEST
BERANGKAT DEPOSIT
TANGGAL TIME 12 PM
ARRIVAL DATE DEPARTURE DATE
DATANG TANGGAL
DARI BERANGKAT
TUJUAN BERIKUTTANGGAL
ARRIVAL
COMING FROM DATE DEPARTURE DATE
NEXT DESTINATION
NAMA KELUARGA
DATANG DARI TUJUAN BERIKUT
COMING
FAMILY NAME FROMFIRST NEXT DESTINATION
NAMA
KEBANGSAANKELUARGA TANGGAL LAHIR
FAMILY
NATIONALITY NAME FIRST DATE OF BIRTH
KTP NO. OR SIM
KEBANGSAAN TANGGAL LAHIR
NATIONALITY
PASPORT NO. DATE OF BIRTH
KTP NO. OR
DATE AND PLACE OF SIM PEKERJAAN
PASPORT NO.
ISSUE KTP/SIM/PASSPORT PROFESSION
DATE
COMPANY AND PLACE
NAME OF PEKERJAAN
ISSUE
RESERVATIONKTP/SIM/PASSPORT
MADE BY PROFESSION
COMPANY
FIRST VISITNAME VISA# PART OF ENTRY
□RESERVATION
YES DNO MADE □ BY □
FIRST VISIT VISA# □ BUSINESS□ □OF
PART ENTRY □ LEASURE
□PURPOSE
YES DNOOF VISIT: □ OFFICIAL
ALAMAT RUMAH
PURPOSE OF VISIT: □ BUSINESS □ OFFICIAL □ LEASURE
HOME ADDRESS
ALAMAT RUMAH CASH COMPANY BCA
HOME ADDRESS
LIPPO MASTER CARD VISA OTHERS
SAFE DEPOSIT BOXES GUEST
CASH SIGNATURE
COMPANY BCA
This Hotel regrets
LIPPO MASTER it canCARD
no accept VISA OTHERS
liabilityDEPOSIT
SAFE for BOXES GUEST SIGNATURE
valuables
This Hotelleft in theit room.
regrets can noSafe
accept
deposit for
liability boxes
valuables left in the room. Safe
deposit boxes