Universal
Credit Card Form
Please fill in full this form with your computer keyboard in CAPITAL LETTERS,
then PRINT and SIGN
and fax it to Guatemalaweb - Posada Belen for their exclusive use
In
GUATE Fax To: ++ 502 2251 3478 . add your international exit code
first.
In USA fax to:1
(302) 361- 9942
DATE
DESCRIPTION OF SERVICES TO CHARGE
AMOUNT USD
TOTAL USD TO CHARGE CARD:
PASSENGERS
NAMES and COMMENTS:
CUSTOMER
NAME:
E-MAIL :
CREDIT
CARD TYPE:
I hereby authorize
GuatemalaWeb or Posada Belen to charge my credit card:
VISA:
, MC: ,AMEX:, DISC: for confirmed services as outlined above
CARDHOLDER EXACT CARD NAME
CARD NUMBER:
EXPIRATION:
SECURITY CODE
THE 3 LAST DIGITS in
the BACK of Visa/MC CARD in AMEX 4 located in the FRONT
BILLING STREET
BILLING
CITY:
BILLING ZIP
CODE:
ESTATE/REGION:
BILLING COUNTRY:
TEL:
FAX:
PASSPORT
NUMBER:
PASSPORT
COUNTRY:
BIRTH DATE:
I have read the Cancellation
and no-show policy detailed in each ptoduct web site I am
paying here and accept it.