Express Checkout

Guest Signature/TandaTanganTamu
Regardless of charge instructions, I hereby acknowledge to be
Personally responsible for the payment ofaccounts
Dengan memahami instruksi penagihan yang ada, sayamengetahui
Bahwasayapribadiakan bertanggung jawab atas seluruh pembayaran

REGISTRATION FORM : INAP

ArrivalDate/Tgl.Kedatangan Boat/ETA/NameSpeedBoat DepartureDate/TanggalKeberangkatan Boat/ETD/NameSpeedBoat

25 December 2021 Private Boat 26 December 2021 Private Boat

No. ofGuests/JumlahTamu Room Type/JenisKamar Rate/Tarif Room/No.Kamar Confirmation No. /No.Konfirmasi

12 + 4 3 Bedroom B 39 & 38 BR2526D2021

Name/Nama Surname First and Middle Name

(Mr/Mrs/Ms) Nama Keluarga Nama Depan dan Tengah

Mrs Putu Riska Passport No./ID No

No.Passport/No. KTP/SIM

Address/ Residential/Rumah N
Alamat
Jakarta Nationality/Kebangsaan Indonesia
Indonesian
Date of Birth/Tgl.Lahir
N

City/Kota State/Province/Propinsi Company/Perusahaan

Jakarta

Country/Negara Postal Code/KodePos Position/Occupation/Posisi/Jabatan

Telephone Mobile/handphone E-mail

Mode of Payment/Pembayaran
Cash/Tunai AmericanExpress BCACard Traveller’sCheques

VisaCard Diners Card Voucher Others(please specify)/Lain-lain

MasterCard JCBCard CompanyAcct./Perusahaan TransferBank

Card Number /No.Kartukredit Expiry

Dear Guest, Please Note the following / Denganhormat, mohondiperhatikan

a. Check out time is 12:00 and check in time is 14:00 /Waktukeberangkatan pada pukul 12:00 siangdanwaktukedatanganpadapukul14.00
b. Thehotelwillnotbeheldresponsibleforlossofmoneyorvaluablesleftinthe rooms.Safetydepositboxesareavailableatthe room freeofcharge/
Hotel tidakbertanggungjawabataskehilanganuangataubarangberharga yang di dalamkamar. Kotakpengamantersedia di kamarsecaracuma-cuma
c. Room rate are Subject to 21% service charge and prevailing government tax/Harga kamar belum termasuk 21% biaya pelayanan dan pajak pemerintah yang
berlaku
d. Smoking is prohibited in our rooms, IDR 500.000 will be applied on your room folio if smoking is evident to have been found / Dilarang MEROKOK, apabila
merokok di dalam kamar akan didenda IDR500.000
e. Please re-turn thekey upon check out, IDR 50.000/key will be applied if its lost / Diharapkan mengembalikan kunci kamar pada saat meninggalkan hotel,
apabila kunci kamar hilang akan di denda IDR 50.000/kunci yanghilang.

Hotel Use only/Hanyadiisiolehpetugas Hotel

REMARKS/Keterangan
Guest Signature/TandaTanganTamu Additional Extra Bed Rp. 250.000 ,-

Regardless of charge instructions, I hereby acknowledge to bePersonally responsible for the Check In/Kedatangan Check Out/Keberangkatan
payment of accounts / Dengan memahamiinstruksipenagihan yang ada, sayamengetahui 25 Dec 2021 26 Dec 2021
bahwasayapribadiakanbertanggungjawabatasseluruhpembayaran